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Cerebral venous thrombosis
Suzanne M Silvis1, Diana Aguiar de Sousa2, José M Ferro2
1Department of Neurology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
Insights
Cerebral venous thrombosis (CVT), a stroke cause in young adults, presents variably, often delaying diagnosis. Recent data improve understanding of CVT epidemiology and treatment, though mortality remains significant.
Area of Science:
- Neurology
- Vascular Medicine
- Public Health
Background:
- Cerebral venous thrombosis (CVT) is a significant cause of stroke, particularly in young adults.
- Recent decades have seen improved understanding of CVT epidemiology, clinical features, and prognosis due to large international registries.
- The diverse and often subtle presentation of CVT symptoms frequently leads to delayed or missed diagnoses.
Purpose of the Study:
- To provide a comprehensive and contemporary review of cerebral venous thrombosis in adults.
- To highlight advancements in CVT epidemiology and treatment over the past decade.
- To emphasize the importance of evidence-based therapeutic approaches for CVT.
Main Methods:
- Review of data from large international registries.
- Analysis of clinical manifestations and prognostic factors.
- Synthesis of current therapeutic strategies and evidence from clinical trials and cohort studies.
Main Results:
- CVT exhibits highly variable clinical presentations, ranging from mild headaches to coma.
- Despite decreased mortality in recent decades, CVT still carries a 5-10% mortality rate.
- Significant progress has been made in understanding CVT, yet diagnostic delays persist.
Conclusions:
- CVT remains a critical neurological condition requiring timely diagnosis and appropriate management.
- Evidence-based therapeutic strategies, guided by robust clinical data, are essential for optimizing CVT outcomes.
- Continued research and awareness are crucial for improving the prognosis of cerebral venous thrombosis.
Abstract:
Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults. Data from large international registries published in the past two decades have greatly improved our knowledge about the epidemiology, clinical manifestations and prognosis of CVT. The presentation of symptoms is highly variable in this disease, and can range from a patient seen at the clinic with a 1-month history of headache, to a comatose patient admitted to the emergency room. Consequently, the diagnosis of CVT is often delayed or overlooked. A variety of therapies for CVT are available, and each should be used in the appropriate setting, preferably guided by data from randomized trials and well-designed cohort studies. Although deaths from CVT have decreased in the past few decades, mortality remains ∼5-10%. In this Review, we provide a comprehensive and contemporary overview of CVT in adults, with emphasis on advancements made in the past decade on the epidemiology and treatment of this multifaceted condition.