Central Nervous System Venous Thrombosis: The Role of CT & MRI. A Review

The clinical presentation of central nervous system venous thrombosis (CNSVT) is variable and non specific. Advances in CT and MRI technology have redefined the role of these 2 modalities in assessing suspected CNSVT. T1, T2, FLAIR and DWI/ADC (diffusion weighted imaging/apparent diffusion coefficient) MRI (magnetic resonance imaging) sequences together with a gadolinium enhanced MRV (magnetic resonance venography) would the imaging of first choice in suspected venous thrombosis of the central nervous system. Where there are still problems with identifying the thrombus and this is crucial to the management, a CTV (computed tomographic venography) should be performed. Catheter angiography would be used as a last resort or associated with direct thrombolysis. There may be circumstances where CT may be used as the first choice. There may be contraindication to MRI such as pacemakers, aneurysms clips etc.