Clinical Spectrum of Sinus Venous Thrombosis

Risk Factors for Peripartum and Postpartum Stroke and Intracranial Venous Thrombosis

“…2 Both values are within the wide range of estimates reported in the literature (see Table 3 for population-based studies). 1,2,5,11 Nevertheless, the rates for peripartum IVT should be considered tentative estimates because of the extreme variability of estimates in the literature, the wide variability in clinical presentation and application of diagnostic technologies, [13][14][15] the relatively high proportion of such cases among all peripartum cerebrovascular events in the present study compared with some 1,5 (but not all) 4 studies that incorporated medical record review, and the low morbidity and zero mortality rates among the present cases. In general, earlier studies (that reported any cases) reported much higher rates of IVT during pregnancy and the puerperium, but these studies used data collected before the advent of CT and MRI, and most of the cases in these studies did not have documentation by either angiography or autopsy.…”

“…39 -43 However, the reliability and accuracy of diagnosis of IVT are probably less than those for other forms of cerebrovascular disease. [13][14][15]25,44 In addition, reported frequencies of comorbidities may be underestimates, because of bias against the recording and coding of chronic comorbid conditions on computerized discharge abstracts. Third, routine hospital discharge diagnoses may be somewhat less accurate than standard clinical diagnoses (eg, because of variation and errors in medical record abstraction and coding), [45][46][47] although the reliability of abstraction of cerebrovascular disease diagnoses from the medical record is fairly good for the broad category of stroke.…”

Cerebral venous and sinus thrombosis

“…Thrombosis of deep cerebral veins is rare, and may appear as diencephalic oedema mimicking tumour or thalamic haemorrhage. Since thrombosis and endogenous fibrinolysis occur concurrently, symptoms are typically fluctuating and in the majority of cases (65-70 %) the mode of onset is subacute or lingering [1,19] but may be more acute (80 %) in CVST related to pregnancy and puerperium [11].…”

“…Headache is the most frequent symptom of CVST and occurs in 75-95 % of all cases [1,17,19]. In most cases, headache precedes the development of other neurological deficits for days,even weeks or exceptionally months.…”

“…The exact incidence is unknown since population-based studies are not available but one can expect 5 to 8 cases per year in a tertiary care centre [3,19]. The disease occurs in all age groups with peak incidences in neonates and in adults in their third decade with a female/male ratio of 1.5-5 [17,19].…”