Cerebral venous sinus thrombosis: A diagnostic challenge in a rare presentation

Alshoabi, Sultan Abdulwadoud

doi:10.4103/bc.bc_27_17

Cited by 13 publications

(16 citation statements)

References 12 publications

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“…We retrospectively identified 95 newly diagnosed patients with CVT and 41 age- and sex-matched individuals for the control group admitted to our hospital from March 2015 to March 2018. Inclusion criteria for our study were newly diagnosed CVT on magnetic resonance imaging (MRI), magnetic resonance venography (MRV), computed tomographic venography (CTV), or conventional digital subtraction angiography (DSA) [1, 23]. The age and sex were unlimited.…”

Section: Methodsmentioning

confidence: 99%

Inflammation is correlated with severity and outcome of cerebral venous thrombosis

Wang

Duan

Bian

et al. 2018

J Neuroinflammation

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BackgroundFew studies have suggested a relationship between inflammation and cerebral venous thrombosis (CVT). This retrospective study aimed to explore the changes in inflammation in different CVT stages and the correlation between inflammation and severity and outcome of CVT.MethodsIn total, 95 suitable patients with CVT and 41 controls were compared. Patients with CVT were divided into three groups. The inflammatory factors studied included hypersensitive C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood and immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) in the cerebrospinal fluid (CSF). The severity of CVT was evaluated with the modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), fundus condition, intracranial pressure (ICP), and complications on admission. The short-term outcome was evaluated with the mRS at discharge.ResultsThe following results were obtained: (1) Inflammatory factor levels in patients with CVT were higher than those in the controls. (2) Inflammatory factor levels in the acute and subacute stages were significantly higher than those in the chronic stage (all P < 0.05). (3) Serum NLR and CSF IgM levels were positively related to baseline degree of disability (odds ratio [OR], 1.279, 95% confidence interval [CI] 1.009–1.621, P = 0.042; OR 1.402, 95% CI 1.036–1.896, P = 0.028). The Hs-CRP level was positively correlated with the baseline occurrence of seizure (OR 1.040, 95% CI 1.001–1.080, P = 0.043). The baseline serum NLR (r = 0.244, P = 0.017), CSF IgA (r = 0.615, P < 0.001), CSF IgM (r = 0.752, P < 0.001), and CSF IgG (r = 0.248, P = 0.015) levels were positively associated with NIHSS. (4) The baseline NLR was significantly associated with high risk of poor outcome at discharge (OR 1.339, 95% CI 1.097–1.784, P = 0.007). Moreover, the ROC showed that NLR ≥ 4.205 could better predict the poor outcome at discharge. The data were analyzed using SPSS.ConclusionsInflammation may develop after CVT and gradually decrease during the course. Inflammation was significantly correlated with severity on admission and short-term poor outcome at discharge in CVT.

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Section: Methodsmentioning

confidence: 99%

Inflammation is correlated with severity and outcome of cerebral venous thrombosis

Wang

Duan

Bian

et al. 2018

J Neuroinflammation

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“…7 However in 10-40% cases, CT scan brain may fail to detect CVST. 7,8 MRI is more sensitive for CVST than CT scan. 8 Absence of normal flow void in T1 and T2 image is the commonest finding in all CVST cases.…”

Section: Discussionmentioning

confidence: 93%

“…7,8 MRI is more sensitive for CVST than CT scan. 8 Absence of normal flow void in T1 and T2 image is the commonest finding in all CVST cases. 8 MRV gives the most accurate finding in CVST to find location of blockage.…”

Section: Discussionmentioning

confidence: 93%

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Sigmoid Sinus Thrombosis with Cerebellar Tuberculous Abscess: A Rare Case of Chronic Headache with Vision Loss

Islam

Uddin

Ali

et al. 2019

J Coll Physicians Surg Pak

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Cerebral venous sinus thrombosis (CVST) is a rare form of brain stroke which is often misdiagnosed. We present a case of CVST due to cerebellar tuberculous abscess. A 41-year female patient was admitted with chronic occipital headache, diminished vision, and fever. The initial brain CT scan was negative, but subsequent imaging (MRI with MRV) showed cerebellar abscess with sigmoid sinus thrombosis. Fundoscopy revealed bilateral optic atrophy. Marked improvement (subjective and objective) was noted after 4 weeks with anti-tuberculosis chemotherapy and anticoagulants. Vision loss was irreversible due to optic atrophy. The case is extremely rare due to the location, rare causative organism (tuberculosis) and complex clinical presentation (occipital headache with vision loss).

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“…Another challenge to diagnosing CVST is the use of proper imaging to visualize the defect. Head CT is often the initial imaging used, although it is only positive in about 30% of the CVST cases [4,9,12]. CTV has significantly improved sensitivity compared to other CT imaging techniques [4,11].…”

Section: Discussionmentioning

confidence: 99%

Not Just Another Headache: Cerebral Venous Sinus Thrombosis in a Patient With Isolated Antithrombin III Deficiency

Findakly

Komro

2020

Cureus

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Cerebral venous sinus thrombosis (CVST) is a rare condition. Symptoms and signs arise from a combination of thrombosis of cerebral veins and increased intracranial pressure. The most common presenting symptom is a non-descriptive headache, but presentation varies with underlying etiology. CVST requires a high index of suspicion to diagnose, particularly in those without apparent risk factors. Evaluation and diagnosis should include a combination of a thorough history, ophthalmoscopic examination, laboratory studies, and imaging. Management is multidimensional and aims to reverse the underlying causes, and prompt treatment with anticoagulation by heparin to decrease thrombotic burden, risk of permanent neurological deficits, and death. In the present study, we report the case of a 61-year-old man referred to the emergency department by an ophthalmologist for bilateral papilledema and eventually diagnosed with CVST secondary to isolated antithrombin III deficiency. Although CVST is uncommon, this case is worthwhile to report as the presentation is unique, and it requires a high index of clinical awareness for timely diagnosis and early therapeutic intervention.

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Cerebral venous sinus thrombosis: A diagnostic challenge in a rare presentation

Cited by 13 publications

References 12 publications

Inflammation is correlated with severity and outcome of cerebral venous thrombosis

Inflammation is correlated with severity and outcome of cerebral venous thrombosis

Sigmoid Sinus Thrombosis with Cerebellar Tuberculous Abscess: A Rare Case of Chronic Headache with Vision Loss

Not Just Another Headache: Cerebral Venous Sinus Thrombosis in a Patient With Isolated Antithrombin III Deficiency

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