Chronic presentation Could be like a pseudotumor syndrome or headaches of mild severity for months like chronic daily headache. Papilledema is usually present. Cortical vein thrombosis could present with seizures. [drrahulchakor.com]

For clinical manifestations, 56 cases (90.32%) presented headache; 16 cases (25.81%) presented choked papilla, 13 cases (20.97%) presented limited neural function defect, 11 cases (17.74%) presented epileptic seizure and 5 cases (8.06%) presented consciousness [spandidos-publications.com]

There was no significant difference between women and men for presentation symptoms. But the most common presentation symptom (43.78%) in women was headache. And the most frequent presentation finding was ICH (34.78%) in men. [dusunenadamdergisi.org]

Clinical presentation The overwhelming majority of patients present with headache [5]. The presentation patterns are secondary to the underlying pathology associated with cerebral thrombosis. [nuemblog.com]

Presentation Occlusion of the cerebral veins or dural venous sinuses may present as a stroke syndrome, subarachnoid haemorrhage or as isolated raised intracranial pressure. [ 1 ] Headache is a common presenting symptom. [ 4 ] It may be sudden like a blow [patient.info]

• Swelling

  A computed tomography scan showed CVST with diffuse swelling of the brain and no contrast enhancement of the straight sinus, superior sagittal sinus and transverse sinus. [nvic.nl]

  Clinical manifestations include dysfunction of cranial nerves III, IV, V, and VI, marked periorbital swelling, chemosis, fever, and visual loss. [fpnotebook.com]

  Symptoms of venous sinus thrombosis may include: Weakness Headaches Pain in the sinus area Pain or pressure in the ear Loss of vision, double vision, or blurred vision Swelling around the eyes Tests for diagnosing sinus thrombosis Your doctor also may [upmc.com]

  The blockage can result in brain swelling (edema), stroke, and/or bleeding in the brain (Figure 2). Any conditions that have a tendency to develop clots can cause cerebral venous sinus thrombosis. [radiology.ucla.edu]

  The pressure around the brain may rise, causing papilledema (swelling of the optic disc ) which may be experienced as visual problems. [royonrescue.com]

• Disability

  Prognosis Although mortality associated with cerebral venous sinus thrombosis is less than 10%, delayed intervention could result in a permanent disability (stroke). [radiology.ucla.edu]

  Bleeding in the brain can lead to compression of vital structures in the brain, causing permanent disability and possibly even death. The procedure for removing blood from the brain is called a decompressive hemicraniectomy. [verywell.com]

  Complications It is important not to miss the diagnosis of intracranial venous thrombosis, as it can result in death and disability. Complications can arise from both the neurological consequences and also from the associated contributory diseases. [patient.info]

  This treatment has greatly reduced the disability and mortality rates of this disease. [2], [3], [4] Due to the diverse etiology and varied clinical course of CVST, and the widely ranging extent of thrombus involvement, a single endovascular treatment [neurologyindia.com]

  If infarction is extensive and involves SWM of both hemispheres bilaterally, there is a high probability of permanent motor and cognitive disability. If foci of infarction are small, unilateral, or unifocal, the outlook may be very good. [clinicaladvisor.com]

• Asymptomatic

  Presentation is variable and can range from asymptomatic to coma and death. Typically patients complain of headache, nausea, and vomiting. Neurological deficits are variable. [radiopaedia.org]

  […] et al. (2005) reported four AVF cases that underwent VS-Stenting to reduce venous pressure and the risk of bleeding; 3 were supplemented with arterial or venous embolization AVF, only 1 underwent stent implantation with a small quantity of residual asymptomatic [medsci.org]

• Fatigue

  Oh, and fatigue - lots of that! I think we are all in a very unique situation and doctors cannot predict our post-recanalization symptoms because the brain is such an unimaginably complex system. [healthboards.com]

• Vomiting

  Conclusions: The current study highlights the burden of CVST in the study population with headache and vomiting, which was the most common presenting complaint. [ruralneuropractice.com]

  The presentations can be of chronic headache for months, or catastrophic with acute onset headache with vomiting, seizures, focal deficits and unconsciousness. [drrahulchakor.com]

  […] infection of the lateral sinuses (transverse/sigmoid sinuses) or mastoiditis Rhinogenic (e.g., after sinusitis ) Through facial infections Meningitis References: [3] [4] [5] Pathophysiology Clinical features Headache (acute, subacute, or chronic) Nausea, vomiting [amboss.com]

  Typically patients complain of headache, nausea, and vomiting. Neurological deficits are variable. [radiopaedia.org]

  She denied any fever, nausea, vomiting or a recent head trauma. Two weeks before, she had a tympanoplasty on the right ear for chronic suppurative otitis media without any immediate post-procedure complications. [panafrican-med-journal.com]

• Visual Impairment

  Unlike arterial events that present suddenly, venous thrombosis can present in either an indolent manner with evolving headache, visual impairment or, more commonly, in a catastrophic manner with seizures, altered mentation or focal neurological deficits [omicsonline.org]

  Visual Loss Severe visual loss due to CVT rarely occurs (2% to 4%). 55, 193, 235 Papilledema can cause transient visual impairment, and if prolonged, optic atrophy and blindness may ensue. [stroke.ahajournals.org]

• Neck Pain

  Headache and neck pain in spontaneous internal carotid and vertebral artery dissections. Neurology. 1995 Aug;45(8): 1517-22. 9) Ferro JM, Costa I, Melo TP, Canhao P, Oliveira V, Salgado AV, Crespo M, Pinto AN. [jhsnet.org]

• Headache

  J Neurosurg Sci. 1999 Mar; 43(1): 25-36. 13) Headache Classfication Subcommittee of International Headache Society. The International Classification of Headache Disorders; 2 nd Edition. [jhsnet.org]

  The presentations can be of chronic headache for months, or catastrophic with acute onset headache with vomiting, seizures, focal deficits and unconsciousness. [drrahulchakor.com]

  The aims of our retrospective study were to detect CVST incidence among patients accessing our outpatient headache day service (DS) programme, whose main symptom was headache, to compare data with pre-existing estimation, and to identify diagnostic and [thejournalofheadacheandpain.springeropen.com]

  Cerebral Venous Sinus Thrombosis: The Forgotten Headache [NUEM Blog. Expert Commentary By Rusinak D]. [nuemblog.com]

• Stroke

  This chain of events is part of a stroke that can occur in adults and children. It can occur even in newborns and babies in the womb. A stroke can damage the brain and central nervous system. [hopkinsmedicine.org]

  Primary Prevention of Ischemic Stroke. Circulation.2006;113:873-23. Kurth T. Migraine, headache, and the risk of stroke in women. Neurology.2005;64:1020- 26. Bousser MG. Estrogens, Migraine and Stroke. Stroke.2004;35:2652-56. 46. Eggers AE. [revistas.upb.edu.co]

  J Stroke Cerebrovasc Dis 2013;1-5. [ Links ] 14. James AH, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol 2005;106:509-16. [ Links ] 15. [scielo.org.mx]

  In some cases, increased intracranial pressure from large strokes requires the induction of hypothermia or cooling of the body's temperature, which helps to prevent further damage to the brain. [verywell.com]

• Seizure

  Patients with infection, seizure or ICH have a greater risk of death. [nature.com]

  If a seizure does not occur, seizure prophylaxis is not necessary. 1,2,11,39 Further testing for underlying etiology is recommended, including thrombophilia. 1,2,3,6 Follow up imaging at 3-6 months is required to assess for recanalization of the affected [emdocs.net]

  Patients started on anticoagulants had reduced occurrence of headache, seizures, focal deficits and intracranial hemorrhage [ 6, 7 ]. [omicsonline.org]

  Seizures, including focal, generalized, and status epilepticus, are seen in 30–40% of patients [7,11]. As seizures are rare in strokes, CVT should be considered in any patient with a focal neurologic deficit and seizure [1,2]. [epmonthly.com]

• Intracranial Hemorrhage

  Patients started on anticoagulants had reduced occurrence of headache, seizures, focal deficits and intracranial hemorrhage [ 6, 7 ]. [omicsonline.org]

  These include intracranial or parameningeal infection (meningitis, encephalitis, brain abscess); malignancy; intracranial hemorrhage such as subdural hemorrhage (SDH), intraventricular hemorrhage (IVH), and subarachnoid hemorrhage (SAH); hypertensive [clinicaladvisor.com]

  Since anticoagulation and thrombolysis have the possibility to aggravate concurrent intracranial hemorrhage, these therapies are contraindicated in cases of CVST combining intracranial hemorrhage and infarction. [neurologyindia.com]

  Thus, anticoagulation is warranted with or without the presence of intracranial hemorrhage on presentation, as anticoagulation is associated with a significant reduction in death [1–6,35]. [epmonthly.com]

  References Rael JR (1997) Direct thrombolysis of superior sagittal sinus thrombosis with coexisting intracranial hemorrhage. American Journal of Neuroradiology 18: 1238-1242. [jneuro.com]

• Aphasia

  - Focal neurologic deficits - hemiparesis, weakness in both lower limbs, aphasia, ataxia, visual disturbance - Drowsiness progressing to coma over few hours or days to week. - Cavernous sinus thrombosis with proptosis, chemosis with septicemia. [drrahulchakor.com]

  Possible neurological signs include hemiparesis, weakness of the lower limbs, sometimes bilaterally, aphasia, ataxia, chorea and hemianopia. [patient.info]

  […] oculomotor palsy) Cortical vein thrombosis: motor deficits, sensory deficits, seizures Sagittal sinus thrombosis: motor deficits, bilateral deficits, seizures Lateral sinus thrombosis: isolated intracranial hypertension Left transverse sinus thrombosis: Aphasia [lifeinthefastlane.com]

  Thrombosis of the left transverse sinus can present as aphasia, while thrombosis of the deep venous sinus can cause behavioral symptoms due to lesions in the thalamus. [epmonthly.com]

  Other reported symptoms include hemiparesis, aphasia, coma and papilloedema [ 1, 13 ].Our patients presented with headache, seizures, hemiparesis and papiloedema. [panafrican-med-journal.com]

An extensive workup should be done to exclude systemic vasculitis such as Behçet’s disease. [jmedicalcasereports.biomedcentral.com]

Park Neurosurgical Focus. 2018; 44(2): E12 [Pubmed] | [DOI] 2 New Developments in the Pathophysiology, Workup, and Diagnosis of Dural Venous Sinus Thrombosis (DVST) and a Systematic Review of Endovascular Treatments Sanjay Konakondla,Clemens M. [neurologyindia.com]

(See Workup.) Left lateral sinus thrombosis demonstrated on magnetic resonance venography (MRV). This 42-year-old woman presented with sudden onset of headache. Physical examination revealed no neurologic abnormalities. [emedicine.medscape.com]

Subsequent workup led to an angiogram, where sagittal sinus thrombosis with extensive trans-cerebral and trans-osseous emissary vein collateral channels was seen. In retrospect, these findings were present on the patient’s earlier contrast MRI. [neuroangio.org]

Treatment Anticoagulation, the administration of a blood thinning drug is the first line of treatment and has been shown to be very effective. [radiology.ucla.edu]

Treatment should begin immediately and must be done in a hospital. [hopkinsmedicine.org]

Between October 2006 and June 2012, 26 CVST patients received endovascular treatment at our hospital. All had a history of progressive neurologic symptoms that did not resolve with medical treatment. [neurologyindia.com]

was regarded as the treatment standard. 2015 Elder [ 18 ] Venous sinus stenting is a valuable treatment for fulminant idiopathic intracranial hypertension A good treatment effect for explosive IIH with auxiliary cerebrospinal fluid drainage and diversion [medsci.org]

Ongoing controversies regarding etiology, diagnosis, treatment Treatment of neonates with AC is controversial. [clinicaladvisor.com]

Table 4: Predictors influencing the prognosis of pregnancy-related CVT patients. [nature.com]

& symptoms, diagnosis, complications, treatment, prevention, prognosis, and additional useful information HERE. [dovemed.com]

Complications include seizures, hydrocephalus, intracranial hypertension and neurological deterioration. [ 10 ] Prognosis Long-term follow-up suggests a generally good prognosis but there may be residual pyramidal symptoms, epilepsy, visual field defects [patient.info]

In 7 patients, the etiology remained unknown. The most common etiologic factor for women was the use of OCPs (n=7). OCPs’ users comprised the largest group (n=7) in women. We could not find the etiology in four of the men. [dusunenadamdergisi.org]

Prior to the advent and widespread use of antibiotics in developed nations, CVT was largely due to infectious etiologies such as mastoiditis, orbital cellulitis, and facial cellulitis[2]. Risk Factors Table 1. [eyewiki.aao.org]

It is caused by a wide range of etiologies, polycythemia is one among them. Polycythemia is a myeloproliferative disorder that is caused by a variety of etiologies [ 2 ]. [j-stroke.org]

Occasional causes were three primary antiphospholipid antibodies syndrome, one had protein C deficiency, one case was receiving oral hormonal and one case of idiopathic etiology. [pesquisa.bvsalud.org]

Cerebral venous thrombosis: Etiology, clinical features, and diagnosis [Internet]. UpToDate. 2020 [citado 3 enero 2021]. [revistamedicasinergia.com]

Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Thromboembolism and oral contraceptives: an epidemiologic case-control study. Am J Epidemiol. 1969;90:365-80. Vessey MP, Doll R. Investigation of relation between use of oral contraceptives and thromboembolic disease. A further report. [ijrcog.org]

Please refer to the article on cerebral venous thrombosis for a broad discussion on epidemiology and risk factors. Presentation is variable and can range from asymptomatic to coma and death. [radiopaedia.org]

Epidemiology Intracranial venous thrombosis appears to have become more common in recent years. However, this has occurred as modern imaging techniques have improved diagnosis. [patient.info]

Epidemiology, endovascular treatment, and prognosis of cerebral venous thrombosis: US Center Study of 152 Patients. J Am Heart Assoc 2017;6:e005480. DOI: 10.1161/JAHA.117.005480. [ Links ] 7. Ruiz-Sandoval JL, Chiquete E, Bañuelos-Becerra LJ, et al. [scielo.org.mx]

Pathophysiology of Cerebral Venous Thrombosis - An overview Abstract Cerebral venous sinus thrombosis is a disorder with a unique pathophysiology which needs to be described.A Medline search of all articles detailing pathophysiology of CVST was done, [jpma.org.pk]

Dehydration Infectious Otogenic (e.g., after acute otitis media ) → generally infection of the lateral sinuses (transverse/sigmoid sinuses) or mastoiditis Rhinogenic (e.g., after sinusitis ) Through facial infections Meningitis References: [3] [4] [5] Pathophysiology [amboss.com]

[…] polyangiitis (formerly known as Wegener’s granulomatosis) Churg-Strauss syndrome Thromboangiitis obliterans Inflammatory bowel disease Sarcoidosis Other disorders Thyroid disease (thyroiditis, hyperthyroidism, hypothyroidism) General Pathology Add text here Pathophysiology [eyewiki.aao.org]

Pathophysiology, clinical manifestations and diagnosis of migraine adults [Internet]. Waltham, MA: Up To Date; 2007 [acceso 10 de octubre de 2007]. [revistas.upb.edu.co]

[…] straight sinus, and then to the internal jugular vein (IJV) Superficial venous system has numerous anastomses and predominantly drain the SSS and the LS Deep white matter and basal ganglia are drained by the deep venous system toward the vein of Galen Pathophysiology [lifeinthefastlane.com]

This prevents blood from draining out of the brain. As a result, blood cells may break and leak blood into the brain tissues, forming a hemorrhage. This chain of events is part of a stroke that can occur in adults and children. [hopkinsmedicine.org]

These medications are given in order to prevent the enlargement of the blood clot inside the affected dural sinus and to prevent the formation of new blood clots which could lead to new and possibly worse strokes. [verywell.com]

[…] is poor with and the condition is known to have a high mortality rate Please find comprehensive information on Cavernous Sinus Thrombosis regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]

Prevention You can do a lot to prevent stroke by leading a heart healthy lifestyle: Eat a low-fat diet including lots of fruits and vegetables. Get daily exercise. Avoid cigarette smoke. Control chronic health conditions, such as diabetes. [womenfitness.net]

You can do a lot to prevent stroke by leading a heart healthy lifestyle: Eat a low-fat diet, including lots of fruits and vegetables. Get daily exercise. Stay away from cigarette smoke. Control chronic health conditions such as diabetes. [cedars-sinai.edu]