Venous stroke–a stroke subtype that should not be ignored

Abstract

Based on the etiology, stroke can be classified into ischemic or hemorrhagic subtypes, which ranks second among the leading causes of death. Stroke is caused not only by arterial thrombosis but also by cerebral venous thrombosis. Arterial stroke is currently the main subtype of stroke, and research on this type has gradually improved. Venous thrombosis, the particular type, accounts for 0.5–1% of all strokes. Due to the lack of a full understanding of venous thrombosis, as well as its diverse clinical manifestations and neuroimaging features, there are often delays in admission for it, and it is easy to misdiagnose. The purpose of this study was to review the pathophysiology mechanisms and clinical features of arterial and venous thrombosis and to provide guidance for further research on the pathophysiological mechanism, clinical diagnosis, and treatment of venous thrombosis. This review summarizes the pathophysiological mechanisms, etiology, epidemiology, symptomatology, diagnosis, and treatment heterogeneity of venous thrombosis and compares it with arterial stroke. The aim is to provide a reference for a comprehensive understanding of venous thrombosis and a scientific understanding of various pathophysiological mechanisms and clinical features related to venous thrombosis, which will contribute to understanding the pathogenesis of intravenous stroke and provide insight into diagnosis, treatment, and prevention.

Cerebral venous congestion alters CNS homeostatic plasticity, evoking tinnitus-like behavior

“…Cerebrovascular homeostasis depends on continuous blood perfusion to deliver oxygen and glucose in order to maintain a normal brain metabolic state [ 28 , 29 ]. Because 70% of the cerebral blood volume is located in the veins, the regulation of the cerebral venous system is as vital as that of the cerebral artery system [ 1 , 3 , 30 , 31 ]. During natural cerebral circulation, cerebral autoregulation prevents and protects the brain from overflow-induced injury.…”

Angulation of the dural venous sinuses of the posterior cranial fossa: Anatomical study with clinical and surgical applications

“…Among the etiological causes associated with CVST, various previous studies have considered and identified general well‐known risk factors (Dentali et al, 2006; Silvis et al, 2018; Zhou et al, 2022). Other hypothetical structural causes have received less attention; nevertheless, since CVST is a multifactorial disorder with a high frequency of cases of unknown etiology, comprehensive consideration of factors concerning the angulation such as those measured in the present study are relevant.…”

“…Previous studies have shown that this entity accounts for 0.5%-1% of all strokes. However, the past incidence of CVST could have been noticeably underestimated compared with current cases, mainly owing to an opportunistic approach to this condition in an emergency setting, its association with the recent pandemic, and its development after SARS-CoV-2 vaccination (Ferro et al, 2021;Jianu et al, 2018;Zhou et al, 2022Zhou et al, , 2023.…”

“…Moreover, several studies have shown the transverse sinus (TS) to be the most common CVST location, its occurrence increasing further in multiple-DVS involvement or when both sides are considered (Bezerra et al, 2022;Duman et al, 2017;Ferro et al, 2004). Regarding the etiological causes of CVST, several well-known general risk factors such as oral contraceptive use, pregnancy, infections, malignancy, and hypercoagulable states have been documented (Bezerra et al, 2022;Duman et al, 2017;Ferro et al, 2021Ferro et al, , 2004Jianu et al, 2018;Zhou et al, 2022Zhou et al, , 2023. Furthermore, other structural factors such as intraluminal bands, intraluminal arachnoid granulations, TS stenosis, absent TS, and extraluminal tumors have been discussed as causes of venographic filling defects and venous flow abnormalities, and are probably implicated in the mechanisms of development of diseases affecting the DVSs such as CVST (Altafulla et al, 2020;Guduri et al, 2023;Iwanaga et al, 2020;Strydom et al, 2010).…”

Neutrophil extracellular traps in central nervous system (CNS) diseases

“…Cerebral stroke includes ischemic stroke and hemorrhagic stroke, and leads to large amount of death with high incidence and teratogenic rate ( Grysiewicz, Thomas & Pandey, 2008 ). On the occurrence of cerebral stroke, especially ischemic stroke, cerebrovascular thrombosis serves as a vital factor ( Ding et al, 2022 ; Hu et al, 2022a ; Zhou et al, 2022 ). So far, NETs have been widely reported to be important in the pathological process of cerebral stoke, and the role of NETs in stroke is most studied among all kinds of CNS diseases.…”