Edit concept Question Editor Create issue ticket

Intracranial Sinus Thrombosis

Cerebral Venous Sinus Thrombosis


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]
  • The first two cases presented as diabetic coma. The third case has been included to represent primary puerperal cerebral venous thrombosis.[ncbi.nlm.nih.gov]
  • 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]
Weakness
  • Possible neurological signs include hemiparesis, weakness of the lower limbs, sometimes bilaterally, aphasia, ataxia, chorea and hemianopia.[patient.co.uk]
  • 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]
  • 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]
  • There was no history of seizures, weakness or loss of consciousness. There was no other significant past medical history. The history and general physical examination did not suggest alcohol related malnutrition.[jscisociety.com]
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]
Splenectomy
  • CVC-associated thrombosis Drugs and diet: Oral contraceptive Hormone replacement Androgens Asparaginase Tamoxifen Corticosteroids Acquired procoagulant states: HONK Dehydration of any other aetiology Pregnancy Polycythaemia Malignancy Nephrotic syndrome Post-splenectomy[derangedphysiology.com]
Recurrent Pulmonary Embolism
  • Recurrent pulmonary embolism in a 13-year-old male homozygous for the prothrombin G20210A mutation combined with protein S deficiency and increased lipoprotein (a). Thromb Res 2002; 105 :49–53. 9 Vaya A, Garcia M, Mira Y, et al.[nature.com]
Amenorrhea
Meningism
  • There were no signs of meningism. A diagnosis of raised intracranial pressure with post-papilloedema optic atrophy was made.[annalsofian.org]
  • 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.[dx.doi.org]
  • One patient had chronic lymphocytic meningitis and was suspected of having either tuberculosis or sarcoidosis. The etiologies varied also and are shown in Table 2 . In 10 patients (25%) no cause was found.[stroke.ahajournals.org]
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]
  • Fundus examination showed bilateral papilledema. Other cranial nerves were normal. There were no peripheral neurological signs noted.[jmedicalcasereports.biomedcentral.com]
  • Signs and symptoms of SSS can include headache, intracranial hypertension and papilledema [ 4, 5, 8 ].[omicsonline.org]
  • 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]
Limb Weakness
Hyperactivity
  • Paulo César Santos-Soares and Jamary Oliveira-Filho , Thrombosis of the Vein of Galen: Pitfalls, Metamorphosis, and Paroxysmal Sympathetic Hyperactivity , Case Reports in Neurology , 9 , 2 , (168) , (2017) .[dx.doi.org]

Workup

  • The rest of the hypercoagulable workup was unremarkable.[path.upmc.edu]
  • 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]
  • Because 47% of our patients were initially diagnosed with pseudotumor cerebri, this study suggests that angiography, or at least brain MRI, should be performed as part of the diagnostic workup in all patients presenting with this condition.[stroke.ahajournals.org]
Hyperviscosity
  • […] the clotting cascade and reduction of cerebral blood flow by stimulation of cerebral vascular smooth muscle contraction have been proposed. [1] Addressing cerebral venous thrombosis in males specifically, some studies suggest dehydration and resultant hyperviscosity[jscisociety.com]

Treatment

  • 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]
  • Louis , Treatment of cerebellar masses , Current Treatment Options in Neurology , 10.1007/s11940-008-0015-z , 10 , 2 , (138-150) , (2008) . José M.[dx.doi.org]
  • […] heparin or low molecular weight heparin in the initial treatment, followed by warfarin, provided there are no other bleeding risks that would make these treatments unsuitable. [4] [10] [11] Some experts discourage the use of anticoagulation if there[en.wikipedia.org]

Prognosis

  • Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue.[dx.doi.org]
  • "Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)". Stroke. 35 (3): 664–70. doi : 10.1161/01.STR.0000117571.76197.26. PMID 14976332.[en.wikipedia.org]
  • 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]
  • […] are associated with a poorer prognosis.[pmj.bmj.com]
  • The prognosis of CVT is worse in elderly patients.[ncbi.nlm.nih.gov]

Etiology

  • This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.[dx.doi.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]
  • 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]
  • If CVST is confirmed, then the etiology of the CVST must be discovered.[omicsonline.org]

Epidemiology

  • 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]
  • American heart association stroke council and the council on epidemiology and prevention.[dx.doi.org]
  • Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • 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]
Sex distribution
Age distribution

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]
  • Lahoti , Therapeutic Advances in Understanding Pathophysiology and Treatment of Cerebral Venous Sinus Thrombosis , American Journal of Therapeutics , 21 , 2 , (137) , (2014) .[doi.org]

Prevention

  • Anticoagulants may prevent new venous infarcts, neurologic deterioration and pulmonary embolism but may also promote haemorrhages.[ncbi.nlm.nih.gov]
  • "Antiepileptic drugs for the primary and secondary prevention of seizures after intracranial venous thrombosis". Cochrane Database of Systematic Reviews. 4 : CD005501. doi : 10.1002/14651858.cd005501.pub4. PMID 27098266.[en.wikipedia.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]
  • Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue.[dx.doi.org]
  • […] manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological basis of strokes that will help practitioners better diagnose, prevent[books.google.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!