Cerebral venous sinus thrombosis on MRI: A case series analysis

Khaladkar, Sanjay M; Thakkar, Dhaval; Thakkar, Dolly; Shrotri, Harshawardhan; Kulkarni, Vilas M

doi:10.4103/0975-2870.128964

Cited by 7 publications

(11 citation statements)

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“…Similar results have been shown in different series. [ 11 12 13 14 15 ] Depending on the availability of collateral venous pathways, CVST can result in significant brain involvement or may be presented as nonspecific symptoms like headache. The mechanism of headache is postulated to be the stretching of nerve fibers in the walls of the occluded sinus and local inflammation, as suggested by the evidence of contrast enhancement of the sinus wall surrounding the clot.…”

Section: Discussionmentioning

confidence: 99%

Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Goyal¹,

Charan²,

Singh³

2018

Ann Indian Acad Neurol

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Introduction:Cerebral venous sinus thrombosis (CVST) is an unusual cause of stroke with potentially serious consequences. This study was designed to investigate the clinical and neuroimaging features in patients with CVST and to analyze the predictors of brain parenchymal lesions.Materials and Methods:A retrospective study of 181 patients with CVST was conducted in a tertiary care hospital.Results:Of 181 patients (age range 14–96 years, mean age: 34.64 ± 14.66 years), 121 were female (66.9%). Most of the patients were in their third decade of life. Headache (47.51%) was the most common clinical presentation followed by seizures (24.31%). Transverse sinus (TS) (77.9%) was the most common site of venous sinus thrombosis. Brain parenchymal lesions were present in 63%, and each patient had subarachnoid and intraventricular hemorrhage. Hemorrhagic venous infarct was the most common brain parenchymal lesion (37.57%). Frontal region (25.4%) was the most common site of brain parenchymal lesions followed by frontoparietal region (21.9%). Women were more likely to have brain parenchymal lesions (72.4%, P = 0.034). Headache was the most common clinical presentation in patients without brain parenchymal lesions while seizures with brain parenchymal lesions. Straight sinus thrombosis was more likely to be associated with brain parenchymal lesions (P = 0.009).Conclusion:CVST presents in young and more commonly in females. TS was the most common site of venous sinus thrombosis. Female gender, seizures, altered sensorium and focal neurological deficit at presentation, and straight sinus thrombosis were more likely associated with the presence of brain parenchymal lesions.

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Section: Discussionmentioning

confidence: 99%

Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Goyal¹,

Charan²,

Singh³

2018

Ann Indian Acad Neurol

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“…In a study by Khaladkar et al in 2014 described similar type of incidence with a maximum number cases (57.5%) in from 21-40 years of age. 4 Cerebral venous thrombosis can affect both the sexes, but there was mild female preponderance seen in our study showing 58% of the cases with cerebral venous thrombosis were females. In a study by Walecki J et al in 2015 showed similar type of results.…”

Section: Discussionmentioning

confidence: 50%

“…In a study by Khaladkar et al in 2014 described that most of the cases of CVT were idiopathic. 4 A study in 2013, Alvis-Miranda HR stated Cerebral venous thrombosis may have a wide range of clinical presentations, however headache was the most common presentation. 9 In our study also, headache is the most common presentation comprising 82% of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…3 MRI and MR Venography are very efficient in detecting Cerebral Venous Thrombosis and the associated parenchymal abnormalities especially the involvement of deep cerebral veins. 4 The aim of this article was to review the knowledge about clinical features, predisposing factors for Cerebral Venous Thrombosis and the role of MRI in diagnosis and prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral Venous Thrombosis – Clinical Profile and Role of MRI in Diagnosis and Prognosis

Sandhya¹,

Jaiganesh²,

Rajasekhar³

2019

IJCMSR

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Inclusion Criteria All patients with Cerebral venous sinus/Cortical vein thrombosis confirmed by MRI. Exclusion Criteria Patients with normal Dural Sinuses/Cortical veins on MRI. Patients with MRI Incompatible Devices such as Cochlear Implants, Cardiac Pacemaker etc. Claustrophobic Patients. Proper Consent to include in the study was obtained from all the patients. The study was conducted after considering and following all the factors of Declaration of Helsinki. RESULTS Wide range of age groups were affected by cerebral venous thrombosis in our study from 2 nd decade to 7 th decade in A B S T R A C T Introduction: Cerebral Venous Thrombosis (CVT) is relatively a rare cause of stroke which is potentially treatable without any permanent neurological deficit if diagnosed early in time. The objective of this study was to describe the etiologies, clinical features and the importance of MRI in diagnosis and prognosis of Cerebral Venous Thrombosis. Material and Methods: This was a prospective study done in 50 consecutive patients diagnosed with cerebral venous thrombosis on MRI in Meenakshi Medical College Hospital and Research Institute, Kanchipuram between April 2016 and March 2018. Detailed history, proper clinical examination and necessary laboratory investigations were done in all the cases. Results: Among 50 patients, most of the cases were seen in 21-50 years of age comprising 92%. The most common presenting symptom was headache(82%) followed by Vomiting(52%), altered sensorium(44%) and seizures(42%). Superior sagittal sinus is the commonest one involved in our study. MRI is helpful to assess the prognosis. Venous infarct is seen in 48% of the cases and diffusion restriction is seen only in 8% of cases. Conclusion: Clinical presentation of Cerebral venous thrombosis(CVT) is vague and high degree of clinical suspicion should be there in young patients presenting with headache, seizures or papilledema. MRI plays a very vital role in the diagnosis and prognosis. Heparin, anticoagulants, antiepileptics and symptomatic treatment play the key role in management. Cerebral venous Thrombosis has very good prognosis provided early diagnosis is made and proper treatment started in time.

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“…Most of the patients had involvement of more than one sinus. 11 Commonest association was noticed between superior sagittal sinus and transverse sinuses. Greiner et al concluded that in veno-occlusive stroke, the superior sagittal sinus followed by transverse, sigmoid, and straight were generally involved.…”

Section: Discussionmentioning

confidence: 99%

Role of magnetic resonance venogram, diffusion and susceptibility weighted imaging in diagnosis of cerebral venous thrombosis

2016

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Background: Cerebral venous thrombosis (CVT) is an uncommon and sometimes critical disease, especially in untreated patients. CVT is an elusive diagnosis because of its nonspecific presentation and its numerous predisposing causes. Accurate diagnosis is difficult but important because effective therapies, including anticoagulants and intrasinus thrombolysis are available. Patients with cerebral venous thrombosis often make dramatic recoveries after anticoagulation. For this reason, accurate diagnosis is important and critical. The aim was to study the extent of venous sinus involvement and associated cerebral parenchymal changes on magnetic resonance venogram (MRV); to study the pattern of diffusion weighted images and ADC (apparent diffusion coefficient) mapping in patients with cerebral venous thrombosis; to study the role of susceptibility weighted images in patients with cerebral venous thrombosis. Methods: Study was conducted on 34 patients diagnosed to have cerebral venous thrombosis on imaging. Results: Imaging analyses of 34 patients (19 females, 15 males, and age range 19-75 years) were done. Thrombus on MRV was seen as loss of high flow signal from the sinus in cases of complete occlusion of the sinus and frayed or patchy flow signal in the cases of non-occlusive thrombus. 16 patients with hemorrhagic infarct showed heterogeneous signal intensity on DWI (diffusion weighted imaging) and blooming on SWI (suseptibility weighted imaging) sequence. 13 patients with non-hemorrhagic infarct showed multifocal high signal intensities in DWI with variable ADC values and no blooming on SWI. 5 patients with intracerebral hematoma showed areas of heterogeneous signals on DWI with blooming on SWI, corresponding ADC values were variable. Conclusions: MRV, diffusion and susceptibility weighted imaging can be used to evaluate the extent of thrombus, discriminate between different types of edema, detect intracerebral hematoma, hemorrhagic and non-hemorrhagic infarcts, and deliver time-saving information for early diagnosis of CVT.

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Cerebral venous sinus thrombosis on MRI: A case series analysis

Cited by 7 publications

References 0 publications

Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Cerebral Venous Thrombosis – Clinical Profile and Role of MRI in Diagnosis and Prognosis

Role of magnetic resonance venogram, diffusion and susceptibility weighted imaging in diagnosis of cerebral venous thrombosis

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