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Case Report
Pre-proof, online 3 March 2025
Case Report: Central Venous Stenosis-Induced Intracranial Hypertension
Caso clínico: hipertensión Intracraneal Inducida por Estenosis Venosa Central
Santiago Cardona-Collazosa,
Corresponding author
scardonac@javerianacali.edu.co

Corresponding author.
, Ashly Ariasa, Sofia Torres-Figueroab, Carlos Alberto Menesesc, Carlos Andres Varonc
a Surgical Sciences Interest Group, Pontificia Universidad Javeriana Cali
b ICESI University
c Neurosurgery Department, Clínica Nueva de Cali
Article information
Abstract

Intracranial hypertension due to central venous stenosis (CVS) is an under-recognized but potentially morbid complication of central venous catheters that can have a benign course if recognized and treated early. Here we report a case of a 23-year-old woman requiring hemodialysis via right subclavian catheter who presented with an intracranial hypertension syndrome and sudden visual loss secondary to right innominate vein thrombosis that improved after angioplasty treatment. This case illustrates how CVS can alter the pressure gradient between the subarachnoid space and the cerebral venous sinuses by increasing venous pressure, affecting cerebrospinal fluid drainage. Since CVS is a common finding in patients receiving hemodialysis, intracranial hypertension due to central venous stenosis is a differential diagnosis to consider in patients of this type who present with intracranial hypertension syndrome.

Keywords:
Intracranial Hypertension
Central Venous Stenosis
Renal Replacement Therapy
Hemodialysis
Monro-Kellie Doctrine
Resumen

La hipertensión intracraneal debida a estenosis venosa central (CVS) es una complicación poco reconocida pero potencialmente mórbida de los catéteres venosos centrales que puede tener un curso benigno si se reconoce y trata tempranamente. Presentamos el caso de una mujer de 23 años que requirió hemodiálisis mediante catéter subclavio derecho y que presentó un síndrome de hipertensión intracraneal y pérdida súbita de visión secundaria a trombosis de la vena innominada derecha que mejoró después del tratamiento con angioplastia. Este caso ilustra cómo la CVS puede alterar el gradiente de presión entre el espacio subaracnoideo y los senos venosos cerebrales al aumentar la presión venosa, afectando el drenaje del líquido cefalorraquídeo. Dado que la CVS es un hallazgo común en pacientes que reciben hemodiálisis, la hipertensión intracraneal debida a estenosis venosa central es un diagnóstico diferencial a considerar en pacientes de este tipo que presentan síndrome de hipertensión intracraneal.

Palabras clave:
Hipertensión Intracraneal
Estenosis Venosa Central
Terapia de Reemplazo Renal
Hemodiálisis
Doctrina de Monro-Kellie

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