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2.1
Intracranial Sinus Thrombosis
Cranial Sinus Thromboses

Images

WIKIDATA, Public Domain
WIKIDATA, CC BY-SA 4.0
WIKIDATA, Public Domain

Presentation

The previously reported patient had presented with thunder clap headache, seizure and drowsiness. [5] This presentation was thought to be typical of SAH. The initial CT did not depict any diagnostic clues suggestive of sinus thrombosis. [annalsofian.org]

In the ISCVT registry, only 5.1% of patients presented serious residual disability, while 70-85% of patients presented a complete recovery 2 months after follow-up. [dx.doi.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]

We present a case series and literature review to illustrate that CVST can also present with subdural hematoma (SDH). Case Description: Chart review was completed on a retrospective case series of CVST with spontaneous SDH. [surgicalneurologyint.com]

Entire Body System

  • Weakness

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

    However, patient would occasionally complain of transient numbness and tingling on the left side of her face, but no focal weakness or slurred speech was noted and cranial nerves were intact. [omicsonline.org]

    Symptoms may include headache, abnormal vision, any of the symptoms of stroke such as weakness of the face and limbs on one side of the body, and seizures. [en.wikipedia.org]

  • Chills

    She denied fevers, chills, sweats or other systemic symptoms. She denied recent travel. She had no prior pregnancies and was not sexually active. [path.upmc.edu]

Neurologic

  • Meningism

    Conclusion: The pathogenesis of isolated headache in CVT in the absence of intracranial hypertension, SAH, meningitis or intracerebral lesion is unknown but may involve changes in the walls of the occluded sinus. [jnnp.bmj.com]

    There were no signs of meningism. A diagnosis of raised intracranial pressure with post-papilloedema optic atrophy was made. [annalsofian.org]

    […] infections (e.g.sinusitis, otitis media, meningitis, head and neck infections) mechanical injury to the sinuses or jugular veins (e.g. trauma, venous catheterisation, neurosurgical procedures) drugs (e.g. androgens, IV immunoglobulin) haematological [lifeinthefastlane.com]

  • Papilledema

    […] and CVST, as well as the differential diagnosis of pain Understand the concept of papilledema vs. pseudopapilledema Gain knowledge on the differential diagnosis of true papilledema Be able to identify the different stages of papilledema according to [journal.opted.org]

    Two weeks post-intervention, lumbar puncture opening pressure was decreased to 16cmH2O and papilledema was mild-moderate (247/301µ). [neurology.org]

    She had a sixth nerve palsy and papilledema, and the MRI and MRV were normal. CSF had an opening pressure of 46 cm, and normal constituents. [pediatricneurologybriefs.com]

    Fundus examination showed bilateral papilledema. Other cranial nerves were normal. There were no peripheral neurological signs noted. [jmedicalcasereports.biomedcentral.com]

    The clinical manifestations of CSVT vary across age groups and include headache, nausea/vomiting, diplopia, seizures, altered mental status, cranial nerve palsies, and papilledema. [doi.org]

  • Forgetful

    Bilyk, Forget Me Not, Survey of Ophthalmology, 55, 5, (467), (2010). Karen C. Albright, William David Freeman and Brian T. Kruse, Cerebral Venous Thrombosis, The Journal of Emergency Medicine, 38, 2, (238), (2010). Louis R. [doi.org]

Workup

The rest of the hypercoagulable workup was unremarkable. [path.upmc.edu]

Methodological limitations of the study include lack of central review of imaging and absence of uniform etiological workup or treatment. [doi.org]

A hypercoagulability workup performed which included Factor V, Prothrombin Gene mutation, homocysteine; Protein C&S, ATIII, ACE, Fibrinogen, Anti-beta 2 glycoprotein, Anti-Cardiolipin, and Lupus screen were all negative. [omicsonline.org]

Treatment

Data collection and analysis Two reviewers independently extracted outcomes for each of the two treatment groups (anticoagulant treatment and control). [dx.doi.org]

Two review authors independently extracted outcomes for each of the two treatment groups (anticoagulant treatment and control). [ncbi.nlm.nih.gov]

Data collection and analysis Two review authors independently extracted outcomes for each of the two treatment groups (anticoagulant treatment and control). [doi.org]

Prognosis

The prognosis of CVT is worse in elderly patients. [ncbi.nlm.nih.gov]

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.co.uk]

Children who survive CVST have a fair prognosis, and most have normal cognitive and physical development. Mild cognitive deficits and reduction in quality of life are infrequent sequelae. [pediatricneurologybriefs.com]

Etiology

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]

Behçet’s disease seems to be the single most frequent etiology in this part of the world. [stroke.ahajournals.org]

The discussion of this case, coupled with a review of the literature, describes the clinical presentation, explores the possible etiology, offers a noninvasive technique for confirming the diagnosis, and presents the medical management of this condition [pediatrics.aappublications.org]

Common etiologies include hypercoagulable diseases, low flow states, dehydration, adjacent infectious processes, oral contraceptives, hormonal replacement therapy, pregnancy, and puerperium. [journals.lww.com]

Epidemiology

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

Written by international experts, this publication is dealing with epidemiology, risk factors, coagulation disorders, clinical presentation - especially focusing on headache, current neuroradiological treatment, complications and long-term prognosis of [books.google.com]

ICD10 - Code: I67.6 - Nonpyogenic thrombosis of intracranial venous system See also : cerebral venous thrombosis 2 Epidemiology Sinus vein thrombosis occur about 60 times more rarely than than do occlusion of the artery/arteries. [flexikon.doccheck.com]

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.co.uk]

Pathophysiology

The same is true for the present understanding of the pathophysiological basis of the disease, eg, concerning the cerebro-venous circulation, the hemodynamic and neuropathological consequences in particular. [books.google.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]

[…] nasolabial fold epileptic attacks psychological symptoms and personality changes 4.3 Full clinical picture Strong fever paralysis motility disorders of the eye ranging all the way to vision loss exophthalmos chemosis 4.4 End consequences elevated ICP death 5 Pathophysiology [flexikon.doccheck.com]

J Infect, 2004. 48(1): p. 86-90. 7.Filippidis, A., et al., Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment. Neurosurg Focus, 2009. 27(5): p. E3. 8.Karam, C. and S. [degruyter.com]

Prevention

Objectives To assess the effects of AEDs for the primary and secondary prevention of seizures related to ICVT. (1) For the question of primary prevention, we aimed to examine whether AEDs reduce the likelihood of seizures in people who have had an ICVT [doi.org]

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]

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