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Cerebral Venous Sinus Thrombosis

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Management of Cerebrovascular Disorders

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon diagnosis affecting as many as 15.7 patients per million people per year. It affects females more common than males with a ratio of 3:1, and in the majority of cases, there is a predisposing hypercoagulable state or less commonly an underlying cause such as trauma or infection.

The clinical manifestation is extremely varied, but common presenting symptoms, such as headache and seizures, can often be nonspecific. Similarly, the natural history of cerebral venous sinus thrombosis varies widely from a benign self-limiting process to intracerebral hemorrhage and death. An ongoing study on the pathogenesis of cerebral venous sinus thrombosis has implicated in the development of dural arteriovenous fistulas. These potentially disastrous outcomes highlight the need for quick, accurate diagnosis and prompt management.

Though the mainstay of therapy for venous sinus thrombosis remains systemic anticoagulation, there is increasing evidence to support early and aggressive endovascular treatment with catheter-directed thrombolysis and/or mechanical thrombectomy.

As with most cerebrovascular disorders, cerebral venous sinus thrombosis management is best guided by a multidisciplinary team of providers including neurologists, neurosurgeons, and neuroradiologists, with a treatment plan tailored to the individual patient.

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References

  1. Devasagayam S, Wyatt B, Leyden J, Kleinig T. Cerebral venous sinus thrombosis incidence is higher than previously thought. Stroke. 2016;47:2180–2.

    Article  Google Scholar 

  2. Coutinho JM, Zuurbier SM, Aramideh M, Stam J. The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012;43:3375–7.

    Article  Google Scholar 

  3. Daif A, et al. Cerebral venous thrombosis in adults. Stroke. 1995;26:1193–5.

    Article  CAS  Google Scholar 

  4. Bienfait HP, Stam J, Lensing AW, van Hilten JJ. Thrombosis of the cerebral veins and sinuses in 62 patients. Ned Tijdschr Geneeskd. 1995;139:1286–91.

    CAS  PubMed  Google Scholar 

  5. Filippidis A, Kapsalaki E, Patramani G, Fountas KN. Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment. Neurosurg Focus. 2009;27:E3.

    Article  Google Scholar 

  6. Siddiqui FM, Kamal AK. Incidence and epidemiology of cerebral venous thrombosis. JPak Med Assoc. 2006;56:485–7.

    Google Scholar 

  7. Ameri A, Bousser MG. Cerebral venous thrombosis. Neurol Clin. 1992;10:87–111.

    Article  CAS  Google Scholar 

  8. Yadegari S, Ghorbani A, Miri SR, Abdollahi M, Rostami M. Clinical features, risk factors, and outcome of cerebral venous thrombosis in Tehran, Iran. J Neurosci Rural Pract. 2016;7:554–8.

    Article  Google Scholar 

  9. Delgado Almandoz JE, et al. Prevalence of traumatic dural venous sinus thrombosis in high-risk acute blunt head trauma patients evaluated with multidetector CT venography. Radiology. 2010;255:570–7.

    Article  Google Scholar 

  10. Ghuman MS, Salunke P, Sahoo SK, Kaur S. Cerebral venous sinus thrombosis in closed head trauma: a call to look beyond fractures and hematomas! J Emerg Trauma Shock. 2016;9:37–8.

    Article  Google Scholar 

  11. Song SY, et al. Cerebral thrombosis at altitude: its pathogenesis and the problems of prevention and treatment. Aviat Space Environ Med. 1986;57:71–6.

    CAS  PubMed  Google Scholar 

  12. Bendz B, et al. Acute hypoxia and activation of coagulation. Lancet. 2003;362:997–8.

    Article  Google Scholar 

  13. Shrestha P, Basnyat B, Küpper T, van der Giet S. Cerebral venous sinus thrombosis at high altitude. High Alt Med Biol. 2012;13:60–2.

    Article  Google Scholar 

  14. Salehi G, Sarraf P, Fatehi F. Cerebral venous sinus thrombosis may follow a seasonal pattern. J Stroke Cerebrovasc Dis. 2016;25:2838–43.

    Article  Google Scholar 

  15. Schreijer AJM, Reitsma PH, Cannegieter SC. High hematocrit as a risk factor for venous thrombosis. Cause or innocent bystander? Haematologica. 2010;95:182–4.

    Article  Google Scholar 

  16. Yii IYL, Mitchell PJ, Dowling RJ, Yan B. Imaging predictors of clinical deterioration in cerebral venous thrombosis. J Clin Neurosci. 2012;19:1525–9.

    Article  Google Scholar 

  17. Chaudhary MY, et al. Dural arteriovenous malformation of the major venous sinuses: an acquired lesion. AJNR Am J Neuroradiol. 1982;3:13–9.

    CAS  PubMed  Google Scholar 

  18. Wang X, Sun X, Liu H. Clinical analysis and misdiagnosis of cerebral venous thrombosis. Exp Ther Med. 2012;4:923–7.

    Article  Google Scholar 

  19. Wasay M, Kojan S, Dai AI, Bobustuc G, Sheikh Z. Headache in cerebral venous thrombosis: incidence, pattern and location in 200 consecutive patients. J Headache Pain. 2010;11:137–9.

    Article  Google Scholar 

  20. Ferro JM, Canhão P, Stam J, Bousser M-G, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–70.

    Article  Google Scholar 

  21. Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352:1791–8.

    Article  CAS  Google Scholar 

  22. Linn J, et al. Noncontrast CT in deep cerebral venous thrombosis and sinus thrombosis: comparison of its diagnostic value for both entities. AJNR Am J Neuroradiol. 2009;30:728–35.

    Article  CAS  Google Scholar 

  23. Ozsvath RR, et al. Cerebral venography: comparison of CT and MR projection venography. AJR Am J Roentgenol. 1997;169:1699–707.

    Article  CAS  Google Scholar 

  24. Leach JL, Fortuna RB, Jones BV, Gaskill-Shipley MF. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics. 2006;26:S19–41.

    Article  Google Scholar 

  25. Bentley JN, Figueroa RE, Vender JR. From presentation to follow-up: diagnosis and treatment of cerebral venous thrombosis. Neurosurg Focus. 2009;27:E4.

    Article  Google Scholar 

  26. Bousser M-G. Cerebral venous thrombosis. Stroke. 1999;30:481–3.

    Article  CAS  Google Scholar 

  27. Einhäupl KM, et al. Heparin treatment in sinus venous thrombosis. Lancet. 1991;338:597–600.

    Article  Google Scholar 

  28. de Bruijn SFTM, Stam J. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke. 1999;30:484–8.

    Article  Google Scholar 

  29. Saposnik G, et al. Diagnosis and management of cerebral venous thrombosis. Stroke. 2011;42:1158–92.

    Article  Google Scholar 

  30. van Dongen CJ, van den Belt AG, Prins MH Lensing A. In: Prins MH, editors. Cochrane Database of Systematic Reviews. CD001100. John Wiley & Sons, Ltd; 2004. https://doi.org/10.1002/14651858.CD001100.pub2

  31. Canhão P, Falcão F, Ferro JM. Thrombolytics for cerebral sinus thrombosis: a systematic review. Cerebrovasc Dis. 2003;15:159–66.

    Article  Google Scholar 

  32. Wasay M, et al. Nonrandomized comparison of local Urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis. Stroke. 2001;32:2310–7.

    Article  CAS  Google Scholar 

  33. Stam J, Majoie CBLM, van Delden OM, van Lienden KP, Reekers JA. Endovascular thrombectomy and thrombolysis for severe cerebral sinus thrombosis. Stroke. 2008;39:1487–90.

    Article  Google Scholar 

  34. Rahman M, Velat GJ, Hoh BL, Mocco J. Direct thrombolysis for cerebral venous sinus thrombosis. Neurosurg Focus. 2009;27:E7.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neuro-Interventional Surgery, RIA Neurovascular, Englewood, CO, USA

    Benjamin Atchie & Don Frei

Authors
  1. Benjamin Atchie
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  2. Don Frei
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Corresponding author

Correspondence to Don Frei .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Alejandro M. Spiotta

  2. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Raymond D. Turner

  3. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    M. Imran Chaudry

  4. Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA

    Aquilla S. Turk

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Atchie, B., Frei, D. (2019). Cerebral Venous Sinus Thrombosis. In: Spiotta, A., Turner, R., Chaudry, M., Turk, A. (eds) Management of Cerebrovascular Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-99016-3_40

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  • DOI: https://doi.org/10.1007/978-3-319-99016-3_40

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99015-6

  • Online ISBN: 978-3-319-99016-3

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