The Structural Imaging Characteristics and Its Clinical Relevance in Patients with Cerebral Venous Thrombosis—A Retrospective Analysis from One Single Center in China

Abstract

BackgroundFew studies have investigated structural imaging findings of cerebral venous thrombosis (CVT) in China. The structural imaging [head computed tomography (CT) and routine brain magnetic resonance imaging (MRI)] can assess any parenchymal lesion secondary to the venous thrombosis and reveal direct signs of intraluminal thrombus. In recent years, many patients can be diagnosed with CVT more rapidly and directly by structural imaging. The aim of the present study is to determine the performance of structural imaging in the diagnosis and outcome of CVT in a large cohort single center of Chinese patients.MethodsWe evaluated consecutive patients admitted to our hospital with CVT receiving structural imaging from 1991 to 2015. A neuroradiologist, blinded to clinical data, independently reviewed the structural imaging, including head CT and routine MRI for parenchymal lesions and signs of dural venous sinus thrombosis, as well as the MRV/DSA findings. The Clinical and laboratory data were reviewed and recorded for further analysis.Results117 patients were included in this study, 68 (58.1%) were females. Parenchymal lesions were identified in 56.4% (66/117) of the patients on structural imaging, including focal edema in 30.8%, hemorrhage in 19.7%, and brain swelling in 4.3% of the patients. Patients with parenchymal lesions presented with more often seizures (P < 0.001) and less often headache (P = 0.049). Intraluminal thrombus within the sinuses or veins on structural imaging was found in 28.2% (33/117) of the patients. Patients with both intraluminal thrombus and parenchymal lesions on structural imaging had more acute onset (P = 0.01) and present more consciousness disturbance (P = 0.007).ConclusionIntracranial lesions on structural imaging are frequently found in patients with CVT. Patients with parenchymal lesions on structural imaging, especially with intraluminal thrombus simultaneously, tend to have a severe clinical picture and might lead to a devastating or fatal outcome. Structural imaging may help on early diagnosis and predict the poor outcome of CVT.

Clinical features of patients with cerebral venous sinus thrombosis at plateau areas

“…In addition, neuroimaging findings indicated that the most common sinus affected was sigmoid sinus, the most common number of sinus involvement was "more than two", without difference between two groups. Our results might be inconsistent with other studies, because the proportion of sinus involvement was quite variable due to the type and timing of neuroimaging (Devasagayam et al, 2016;Kalita et al, 2016;Wang et al, 2019;Zhou et al, 2017).…”

Cortical vein involvement and its influence in a cohort of adolescents with cerebral venous thrombosis

“…(1) Edema can be detected on CT or MR images by observing focal irregularities in attenuation or signal intensity. These abnormalities can be further categorized into two types: vasogenic edema, characterized by elevated ADC values that are presumed to be associated with venous congestion, and cytotoxic edema, characterized by reduced ADC values attributed to cellular energy disruption, as revealed by DWI techniques [ 13 ]. (2) Venous infarction is defined as the presence of brain parenchymal lesions that encompass local edema as well as petechial or confluent cerebral hemorrhage [ 14 ].…”

Imaging of cerebrovascular complications of infection

“…Cerebral infectious thrombophlebitis is rare. However, women of childbearing age are at high risk, and about 58.1% of infectious thrombophlebitis occurs in this age group (28). Cerebral venous thrombosis (CVT) accounts for nearly all intracranial thrombosis with incidence 0.5-1.0%, but the incidence increases to as high as 5% of all strokes in the younger population (29,30).…”