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Cerebral Venous Thrombosis: A Comprehensive Review
Pretty Sara Idiculla1, Dhineshreddy Gurala2, Manikandan Palanisamy3
1University of Missouri Health Care, Columbia, Missouri, USA, sarahidiculla.psi@gmail.com.
Insights
Cerebral sinus venous thrombosis (CSVT) is a rare but serious neurological condition. Early diagnosis and treatment, primarily anticoagulation, significantly improve patient outcomes and reduce mortality.
Area of Science:
- Neurology
- Vascular Neurology
Background:
- Cerebral sinus venous thrombosis (CSVT) is a rare, potentially fatal neurological condition.
- Its diagnosis is often delayed due to vague clinical and radiological signs.
Purpose of the Study:
- To provide a comprehensive review of Cerebral sinus venous thrombosis (CSVT).
- Focus on the epidemiology, risk factors, pathophysiology, clinical features, diagnosis, and management of CSVT.
Main Methods:
- Literature search on PubMed using "Cerebral sinus venous thrombosis".
- Included full-text English articles from the last 10 years, focusing on adults (>18 years).
Main Results:
- CSVT accounts for ~1% of all strokes and presents in acute, subacute, or chronic forms.
- Common presentations include intracranial hypertension, focal deficits, and cavernous sinus syndrome.
- MRI with MRV is the gold standard for diagnosis; anticoagulation is the primary treatment.
Conclusions:
- CSVT is under-diagnosed due to nonspecific presentation.
- Timely diagnosis and treatment are crucial for reducing morbidity and mortality.
- Early intervention significantly improves outcomes in CSVT patients.
Background:
Cerebral sinus venous thrombosis (CSVT) is a relatively rare, potentially fatal neurological condition that can be frequently overlooked due to the vague nature of its clinical and radiological presentation. A literature search on PubMed using the keyword "Cerebral sinus venous thrombosis" was performed. We searched for the epidemiology, risk factors, pathophysiology, clinical features, diagnosis, and treatment of CSVT. All full-text articles in the last 10 years, in adults (>18 years), and the English language were included. We aim to give a comprehensive review of CSVT, with a primary focus on the management of the disease.
Summary:
The literature search revealed 404 articles that met our criteria. CSVT is a relatively rare condition that accounts for approximately 1% of all forms of stroke. They can be subdivided into acute, subacute, and chronic forms based on the time of onset of clinical symptoms. It is a multifactorial disease, and the major forms of clinical presentation include isolated intracranial hypertension syndrome, focal neurological deficits, and cavernous sinus syndrome. MRI with magnetic resonance venogram (MRV) is considered the gold standard for diagnosis. Anticoagulation with heparin or low-molecular-weight heparin is the mainstay of treatment. Endovascular management is indicated for those cases with severe symptoms or worsening of symptoms despite anticoagulation therapy. Favorable outcomes have been reported in patients who receive early diagnosis and treatment.
Conclusion:
CSVT is a potentially fatal neurological condition that is often under-diagnosed due to its nonspecific presentation. Timely diagnosis and treatment can reduce morbidity and mortality, remarkably improving the outcome in affected individuals.
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