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Cerebral venous thrombosis in adults
1Vivantes Klinikum im Friedrichshain, Berlin, Germany.
VASA. Zeitschrift Fur Gefasskrankheiten
|April 18, 2019
Summary
Cerebral venous thrombosis (CVT) is a significant cause of stroke in young individuals. Modern imaging has shown CVT is more common and less fatal than previously thought, with anticoagulation as the primary treatment.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Cerebral venous thrombosis (CVT) is a rare but important cause of stroke, particularly in younger populations.
- Historically, CVT carried a poor prognosis, but advances in imaging have revised this understanding.
- Oligosymptomatic cases, often presenting solely with headache, may be underdiagnosed.
Purpose of the Study:
- To review the current understanding of cerebral venous thrombosis (CVT).
- To highlight diagnostic modalities and treatment strategies for CVT.
- To emphasize the changing prognosis and management of CVT.
Main Methods:
- Review of clinical data, imaging techniques, and treatment outcomes for CVT.
- Analysis of population-based studies and registry data.
- Evaluation of diagnostic accuracy of CT-venography and MR-venography.
Main Results:
- CVT is more frequent and less life-threatening than previously assumed, due to improved diagnostic capabilities.
- CT- and MR-venography are effective in diagnosing CVT.
- Laboratory tests like D-dimer lack sufficient sensitivity for reliable diagnosis alone.
Conclusions:
- Anticoagulation is the recommended treatment for acute CVT and secondary prevention, despite limited direct evidence.
- Early diagnosis through advanced imaging is crucial for improving patient outcomes.
- Headache as an isolated symptom warrants consideration for CVT, especially in young adults.
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