Risk Factors for Cerebral Venous Thrombosis

Abstract

Cerebral venous thrombosis (CVT) is a rare thrombotic disorder involving the cerebral veins and dural sinuses. In contrast to more common sites of venous thromboembolism (VTE), such as the legs and lungs, CVT mainly affects young adults and children, and women are affected three times more often than men. Although presenting symptoms are variable, headache is usually the first symptom, often in combination with focal neurologic deficits and epileptic seizures. The primary therapy for CVT consists of heparin followed by oral anticoagulation for at least 3 to 6 months. The mortality in the acute phase is 5 to 10% and a substantial proportion of survivors suffer from long-term disabilities. A large number of risk factors have been linked to CVT, although the scientific evidence for an association varies considerably between risk factors. Some risk factors, such as hereditary thrombophilia, correspond with risk factors for more common sites of VTE, whereas others, such as head trauma, are specific to CVT. In most patients, at least one risk factor can be identified. In this review, we provide an overview of the risk factors for CVT.

Cancer and risk of cerebral venous thrombosis: a case–control study

“…Risk factors for CVT partly overlap with those for leg vein thrombosis and pulmonary embolism, including genetic thrombophilia and oral contraceptive use. However, other risk factors, such as head trauma and ear infections, are specific for CVT . Cancer is generally also believed to be a risk factor for CVT, but controlled studies assessing the association between CVT and cancer have never been performed .…”

CVT in the Peripartum Period: A Diagnostic Dilemma

“…Our patient's thrombophilia screening immediately postpartum excluded possible hematologic predisposition to clotting [11], although she did not present for hematologic testing prior to or after pregnancy. While she was heterozygous for the MTHFR gene and hyperhomocysteinemia promotes vascular damage of the endothelium and has been linked to venous thrombosis, there is no established link with heterozygosity for the MTHFR gene and thrombosis.…”

“…Thrombosis and thromboembolism is a leading cause of pregnancy-associated deaths, and CVT has a reported incidence of 11.6 per 100,000 deliveries per year, accounting for 6-64% of all pregnancy-related strokes [10]. Risk factors for the development of CVT include the hypercoagulable state of pregnancy, infection including sinusitis, head trauma, hypertensive conditions, and most recently, dural punctures after spinal analgesia [5,6,11]. Loss of CSF after dural puncture decreases intracranial pressure, leading to a compensatory cerebral venous and arterial dilation (Monro-Kellie hypothesis), reducing the venous blood flow in dural sinuses by 50% following lumbar punctures [12].…”

Reversible cerebral vasoconstriction syndrome concomitant with cerebral venous sinus thrombosis following ovarian tumor resection: A report of two cases

“…Risk factors include ovarian tumor, iron deficiency anemia, pregnancy, intravenous drug abuse, infection, and dehydration. [10] Headache is the predominant symptom reported in 90% of cases. Papilledema occurs in approximately 30% of cases and is attributed to elevated intracranial pressure.…”