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Cerebral venous thrombosis: a practical review

Afshin Borhani-Haghighi1,2, Etrat Hooshmandi1

  • 1Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz 7193635899, Iran.

Postgraduate Medical Journal
|November 17, 2023
PubMed

Insights

Cerebral venous thrombosis (CVT), often seen in young women, is a serious stroke type. Prompt diagnosis and anticoagulation treatment are crucial for managing CVT and preventing long-term disability.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Infectious Disease Epidemiology

Background:

  • Cerebral venous thrombosis (CVT) has gained attention due to the Coronavirus Disease-2019 pandemic and vaccination efforts.
  • CVT, though less common than arterial stroke, leads to significant years of life lost and disproportionately affects women and younger individuals.

Purpose of the Study:

  • To review the epidemiology, risk factors, clinical manifestations, diagnostic approaches, and management strategies for cerebral venous thrombosis.
  • To highlight the impact of COVID-19 on CVT awareness and incidence.

Main Methods:

  • Literature review of studies on cerebral venous thrombosis, including epidemiological data, clinical presentations, diagnostic imaging (CT, MRI with venous sequences), and laboratory findings (e.g., D-dimer).
  • Analysis of predisposing factors, categorized into transient (e.g., pregnancy, oral contraceptives) and permanent (e.g., thrombophilia, infections like SARS-CoV-2).

Main Results:

  • Common CVT manifestations include headache, seizures, focal neurological deficits, altered consciousness, and cranial nerve palsies.
  • Overlapping clinical syndromes such as stroke-like presentations, raised intracranial pressure (ICP), isolated headache, and encephalopathy are observed.
  • Diagnostic tools include advanced neuroimaging, with D-dimer elevation as a supportive laboratory finding.

Conclusions:

  • Effective CVT management involves anticoagulation to prevent thrombus propagation, ICP reduction strategies (including decompressive craniotomy), and targeted treatment of underlying conditions.
  • Understanding CVT's diverse presentations and risk factors is essential for timely diagnosis and improved patient outcomes.

Keywords:
cerebral venous thrombosiscerebrovascular diseasediagnosissinus thrombosistreatment

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