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Hydrocephalus in cerebral venous thrombosis
Susanna M Zuurbier1, René van den Berg, Dirk Troost
1Department of Neurology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Journal of Neurology
|February 10, 2015
Summary
Hydrocephalus is more common in cerebral venous thrombosis (CVT) than previously thought, particularly with deep CVT and basal ganglia edema. This condition is linked to poorer outcomes, but shunting is not recommended.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Increased intracranial pressure is a known complication of cerebral venous thrombosis (CVT).
- Hydrocephalus, however, is infrequently reported in CVT patients.
- Understanding the incidence and impact of hydrocephalus in CVT is crucial for patient management.
Purpose of the Study:
- To determine the frequency of hydrocephalus in patients with CVT.
- To investigate the clinical manifestations and associated factors of hydrocephalus in CVT.
- To evaluate the impact of hydrocephalus on clinical outcomes in CVT.
Main Methods:
- Retrospective analysis of CVT patients admitted between 2000 and 2010.
- Hydrocephalus defined by bicaudate index or temporal horn width.
- Exclusion of hydrocephalus from non-CVT causes or iatrogenic origins.
Main Results:
- Hydrocephalus was present in 20 out of 99 CVT patients.
- Patients with hydrocephalus more frequently exhibited focal neurological deficits and coma.
- Deep CVT and basal ganglia/thalami edema were significantly more common in hydrocephalus patients.
- Worse outcomes, including functional disability and mortality, were observed in hydrocephalus patients.
Conclusions:
- Hydrocephalus occurs more frequently in CVT than previously recognized, especially in cases involving deep venous thrombosis and basal ganglia edema.
- While associated with worse outcomes, a direct causal link between hydrocephalus and CVT is unlikely.
- Routine shunting procedures for hydrocephalus in CVT are not advised based on current findings.
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