Cerebral venous sinus thrombosis

Capecchi, Marco; Abbattista, Maria; Martinelli, Ida

doi:10.1111/jth.14210

Cited by 173 publications

(200 citation statements)

References 106 publications

(151 reference statements)

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“…CVT refers to thrombosis occurring in the cerebral veins and the dural venous sinuses [1]. The most common sites of thrombosis are the superior sagittal sinus (37-62%) and the lateral sinuses (31-44%) [2,3].…”

Section: Definition and Epidemiologymentioning

confidence: 99%

“…CVT can be secondary to local or systemic risk factors, and in >40% of cases is a multifactorial disorder [1,2]. Local risk factors for CVT mainly include infections (8-12% of patients), such as infections of the ears, sinuses, mouth, face, neck, or the central nervous system (CNS) [2,3].…”

Section: Risk Factorsmentioning

confidence: 99%

“…CVT can potentially mimic an ischemic stroke, however, headache and seizures are more common than in arterial events [1]. Focal neurological deficits are usually secondary to the presence of a venous infarction, and are more common in CVT of the superficial cerebral veins [1]. Aphasia can occur in thrombosis of the lateral sinus of the dominant hemisphere.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…In patients with clinical suspicion of CVT, urgent neuroimaging should be performed. Plain (unenhanced) computed tomography (CT) can show direct signs of CVT (such as the "dense triangle" or the "cord sign"); however, these signs are present only in approximately 30% of patients and their absence is not sufficient to rule out CVT [1]. CT venography can confirm CVT diagnosis by showing the intraluminal filling defects, and has high sensitivity for both dural venous sinus thrombosis (99%) and cerebral vein thrombosis (88%) [1].…”

Section: Diagnosismentioning

confidence: 99%

See 3 more Smart Citations

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Riva

Ageno

2020

JCM

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Cerebral vein thrombosis (CVT) and splanchnic vein thrombosis (SVT) are two manifestations of venous thromboembolism (VTE) at unusual sites. They have an incidence at least 25–50 times lower than usual site VTE, but represent true clinical challenges. Recent evidence on the epidemiology, risk factors, prognosis, and treatment of CVT and SVT has been published in the last two decades, thus contributing to a better understanding of these diseases. The improvement in imaging techniques and a higher degree of clinical suspicion may have led to the observed increased frequency, whereas a better knowledge of provoking mechanisms could have contributed to reducing the proportion of events classified as unprovoked or idiopathic (13–21% of CVT, 15–27% of SVT). Few small randomized clinical trials and a number of observational studies, although hampered by heterogeneous therapeutic approaches, shed light on the safety and effectiveness of anticoagulant therapy in these populations. However, there are still some grey areas that warrant future research. In this narrative review, we discuss recent advances and therapeutic challenges in CVT and SVT.

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Section: Definition and Epidemiologymentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Riva

Ageno

2020

JCM

View full text Add to dashboard Cite

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“…Although it has good sensitivity and specificity, it is an invasive examination. The clinical manifestations of CVST are atypical and prone to misdiagnosis and missed diagnosis, and the diagnosis and treatment of CVST are still a difficult problem for clinicians [7,8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features of Diffuse Leptomeningeal Glioneuronal Tumor With the First Symptom of Headache and Decreased Vision Misdiagnosed as Venous Sinus Thrombosis

Bao

Ding

et al. 2019

J Neurol Res

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Meningeal carcinoma has a variety of clinical manifestations and a high mortality and disability rate. Among them, cranial hypertension is one of the important causes of death, which is easy to be missed or misdiagnosed. The purpose of this case report is to describe the clinical features of diffuse leptomeningeal glioneuronal tumor (DNGNT) with the first symptom of headache accompanied by decreased vision misdiagnosed as venous sinus thrombosis. The patient initially suffered from headache and decreased vision, and rapidly developed blindness. According to the clinical manifestations and cerebrospinal fluid (CSF) examination results, the patient was initially misdiagnosed as venous sinus thrombosis, the intracranial pressure was relieved by Ommaya capsule, and the cerebrovascular condition was observed by magnetic resonance venogram (MRV) and digital subtraction angiography (DSA). The degree of meningeal enhancement was observed by enhanced magnetic resonance imaging (MRI), and meningeal cancer cells were found by CSF cytology. The patient was excluded from viral meningitis, tuberculous meningitis, cryptococcal meningitis, optic neuromyelitis, and central nervous system Behcet's disease by routine examination. Ommaya capsule implantation relieved the intracranial hypertension, and vision was restored after treatment. No venous sinus thrombosis was found in MRV and DSA; brain-enhanced MRI revealed extensive linear enhancement of the meninges, and CSF cytology revealed grotesque, actively dividing tumor cells; she was diagnosed as DLGNT. Meningeal carcinoma cannot be excluded in adolescents without tumor history. When patient has unexplained intracranial hypertension, it is necessary to consider DLGNT; early brain-enhanced MRI and CSF cytology are helpful for early diagnosis. For cranial hypertension, timely placement of Ommaya capsule can improve patient quality of life and save vision in time; molecular targeted therapy as early as possible can prolong survival.

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Predictors of successful endovascular treatment in severe cerebral venous sinus thrombosis

Liu

Duan

et al. 2019

Ann Clin Transl Neurol

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Objective The objective of this study was to evaluate the thrombus characteristics affecting the extent of recanalization to identify patients with severe cerebral venous sinus thrombus ( CVT ) more likely to benefit from endovascular therapy. Methods Severe CVT patients scheduled for endovascular treatment were prospectively recruited into the study. Each thrombosed venous segment was evaluated regarding complete or partial recanalization based on digital subtraction angiography ( DSA ) after treatment. Magnetic resonance black‐blood thrombus imaging ( MRBTI ) was performed 1 day before endovascular treatment. The signal‐to‐noise ratio ( SNR ) of the clot, age of the clot, and baseline volume of the clot were compared between the complete and partial recanalization groups. A logistic regression analysis was performed to identify the association between these clot characteristics and recanalization status. Results Twenty‐one CVT patients undergoing endovascular therapy were prospectively included. There were 110 thrombosed segments, 54 of these segments were completely recanalized after endovascular treatment. An acute clot sign ( ACS ) was found in 39 segments and a subacute clot sign ( SCS ) was found in 71 segments. There was no significant difference on baseline volume of the clot (1638.8 ± 1432.2 mm 3 vs. 1957.5 ± 2056.1 mm 3 , P > 0.05) between the complete and partial recanalization groups. Logistic regression analysis showed that ACS on MRBTI was associated with complete recanalization ( P < 0.001, odds ratio = 3.937, 95% confidence interval, 1.6–9.5). Interpretation ACS can be used to predict complete recanalization in patients undergoing endovascular treatment. MRBTI provides a robust method to define clot composition and is potentially useful in selecting the most appropriate CVT patients for endovascular treatment.

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Cerebral venous sinus thrombosis

Cited by 173 publications

References 106 publications

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Cerebral and Splanchnic Vein Thrombosis: Advances, Challenges, and Unanswered Questions

Clinical Features of Diffuse Leptomeningeal Glioneuronal Tumor With the First Symptom of Headache and Decreased Vision Misdiagnosed as Venous Sinus Thrombosis

Predictors of successful endovascular treatment in severe cerebral venous sinus thrombosis

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