Impact of anatomical difference of the cerebral venous system on microcirculation in a gerbil superior sagittal sinus occlusion model.

Sinus-vein thrombosis (SVT) is known to have a wide spectrum of clinical manifestations, and the formation of venous collateral pathways is considered to be one of the most important factors influencing the individual outcome. Here, we examined the relationship between the anatomical differences in bridging veins and cerebral microcirculation in a gerbil superior sagittal sinus (SSS) occlusion model. In male Mongolian gerbils (n=26), the SSS was ligated close to the confluence sinuum. Four additional animals served as the sham-operated control. Regional cerebral blood flow (rCBF) and haemoglobin oxygen saturation (HbSO2) were assessed by Laser-Doppler flowmetry and a microspectrophotometric method at 36 identical locations in the both hemispheres every 20 minutes for 120 minutes after ligation using a "scanning" technique. Furthermore, we examined change in the diameter of the bridging vein by fluorescence angiography and brain damage by histological investigation after 48 hours. Based on the anatomical findings, the hemispheres were classified into two groups: group A with one bridging vein, n=24/52 sides (46.2%) and group B with more than two bridging veins, n=28/52 sides (53.8%). Significant decreases in rCBF (P<0.05) and rHbSO2 (P<0.05) were seen from 20 minutes after the ligation to the end of the experiment in group A, but not in group B. A detailed analysis of individual cases in changes of local (l) CBF and lHbSO2 revealed three patterns: 1) pattern-1, no change; 2) pattern-2, decrease with following recovery; 3) and pattern-3, decrease without recovery. There were no significant differences in the diameter of the bridging vein and no venous infarction in either groups. The group A frequency, which consisted of pattern-3 (58.3%)>pattern-2 (29. 2%)>pattern-1 (12.5%), was opposite to that of group B, which consisted of pattern-1 (71.4%)>pattern-2 (25.0%)>pattern-3 (3.6%) (P<0.001). Based on the results of this study, the anatomical structure and an opening of the collateral pathways of the venous drainage system are closely related to microcirculatory alterations after venous occlusion. The experimental model is suitable for the study of the pathophysiological mechanism responsible for the high variability of SVT.