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Profile of patients with cerebral venous sinus thrombosis with cerebellar involvement

Girish B Kulkarni1, Veerendrakumar Mustare1, Mirza M Abbas1

  • 1Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|November 16, 2013
PubMed

Insights

Cerebellar involvement in cerebral venous thrombosis (CVT) is rare. Diagnosis requires high suspicion and advanced imaging like MRI, with anticoagulation proving effective. Survivors had no disability, but mortality was 33%.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Cerebral venous thrombosis (CVT) is an uncommon type of stroke with varied clinical presentations.
  • Limited data exists on the specific characteristics and outcomes of patients with cerebellar involvement in CVT.
  • This study aims to elucidate the profile of patients experiencing cerebellar CVT.

Purpose of the Study:

  • To describe the clinical features, diagnostic investigations, and patient outcomes in cases of cerebellar involvement within CVT.
  • To highlight the diagnostic utility of neuroimaging modalities in identifying cerebellar CVT.
  • To assess the efficacy of current management strategies and determine the prognosis for patients with cerebellar CVT.

Main Methods:

  • A prospective study involving 6 patients with cerebellar involvement (1.8% of 330 CVT cases) over three years.
  • Patients included 2 with isolated cerebellar CVT and 4 with associated supratentorial or deep structure involvement.
  • Diagnostic tools included computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV).

Main Results:

  • Presenting symptoms included headache, vomiting, encephalopathy, ataxia, and papilledema, with a mean symptom duration of 7 days.
  • MRI/MRV demonstrated superior diagnostic accuracy over CT, effectively identifying lesions, hemorrhages, and thrombus age.
  • Medical management with anticoagulation, anti-edema, and anti-epileptic drugs was employed; 2 patients underwent posterior fossa decompression, resulting in 4 complete recoveries and 2 deaths (33% mortality).

Conclusions:

  • Cerebellar involvement in CVT is rare, necessitating a high index of suspicion for timely diagnosis.
  • CT and MRI are crucial for confirming the diagnosis, with MRI offering advantages in lesion characterization.
  • Conventional anticoagulation is an effective treatment, though mortality remains significant (33%), with survivors experiencing no disability.
Abstract

Keywords:
Cerebral venous thrombosiscerebellar infarctionthrombosisvenous infarction

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