Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Abstract

Cerebral venous thrombosis (CVT), also called cerebral venous sinus thrombosis (CVST), is a cerebrovascular disease with diverse clinical manifestations that often affects young adults, women of childbearing age, and children. It's most common clinical manifestations are headache, seizures, altered consciousness, and neurological focal signs on physical examination. CVT can manifest as a single symptom, or it can present as a syndrome consisting of multiple symptoms. This non-specific clinical picture makes diagnosing CVT difficult. Although the mortality rate of CVT has been significantly reduced by improvements in treatment and diagnostic techniques, the mortality rate of severe CVT remains as high as 34.2%. Survivors of this type of CVT have varying degrees of residual symptoms and are not able to return to their previous work. Hence, we performed a comprehensive literature search in the PubMed, EMBASE, and Medline databases to review the diagnosis and treatment of CVT.

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

“…Cerebral Venous thrombosis may present with ophthalmic symptoms due to papilledema, loss of vision and constriction of visual field. 11 In our study papilledema was seen in 16 cases(32%) and visual disturbances noted in 5 cases. Superior sagittal sinus (56%) was the commonest one involved in our study, followed by transverse (48%) and sigmoid (36%) sinuses.…”

“…Motor deficits are the commonest form of neurological deficits in patients with cerebral venous thrombosis. 11 In our study, 13 patients had presented with neurological deficits. Cerebral Venous thrombosis may present with ophthalmic symptoms due to papilledema, loss of vision and constriction of visual field.…”

Radiologische Hinweise auf zerebrale Venenthrombose

“…Die prädisponierenden Faktoren und klinischen Manifestationen der tiefen ZVT sind praktisch identisch mit denen der duralen Sinusthrombose (s. oben), wenngleich 61,5 % der Patienten mit einer tiefen ZVT eine herabgesetzte Bewusstseinslage zeigen [65]. Zu den weniger häufigen klinischen Manifestationen zählen fokalneurologische Defizite oder psychiatrische Symptome wie Delir, Amnesie, Apathie oder Mutismus [1,65,66].…”

“…Es ist wichtig, die Signalintensität der umliegenden kortikalen Venen zu beurteilen [78]. In den letzten Jahrzehnten ist die ZVT-assoziierte Mortalität erheblich zurückgegangen: Die berichteten Mortalitätsraten liegen in einem Bereich von 0 -39 % [16,66,80,81]. Die häufigste Todesursache ist eine transtentorielle Einklemmung, die normalerweise Folge von multiplen Läsionen, einem diffusen Ödem oder einem raumfordernden Effekt darstellt.…”

Cerebral Venous Thrombosis Can Be Followed by Electroencephalography: Accompanied By a Case Discussion

“…CVT is a disease especially seen in women receiving hormone therapy, which presents with a broad spectrum of symptoms ranging from mild symptoms such as headache to severe symptoms such as stroke (1). The most common clinical symptoms are headache secondary to focal cerebral edema and intracranial hypertension, focal neurologic deficits due to venous infarction or hemorrhage, and seizures (2). The presentation rate with epileptic seizure is 6-10% and seizures are usually seen in patients with secondary venous bleeding (1).…”