Cerebral venous sinus thrombosis (CVST), cerebral venous and sinus thrombosis or cerebral venous thrombosis (CVT), is the presence of a blood clot in the dural venous sinuses (which drain blood from the brain), the cerebral veins, or both. Symptoms may include severe headache, visual symptoms, any of the symptoms of stroke such as weakness of the face and limbs on one side of the body, and seizures, which occur in around 40% of patients.[2]
The diagnosis is usually by computed tomography (CT scan) or magnetic resonance imaging (MRI) to demonstrate obstruction of the venous sinuses.[3] After confirmation of the diagnosis, investigations may be performed to determine the underlying cause, especially if one is not readily apparent.
Treatment is typically with anticoagulants (medications that suppress blood clotting) such as low molecular weight heparin.[1] Rarely, thrombolysis (enzymatic destruction of the blood clot) or mechanical thrombectomy is used, although evidence for this therapy is limited.[4] The disease may be complicated by raised intracranial pressure, which may warrant surgical intervention such as the placement of a shunt.[3]
^ abAl Rawahi B, Almegren M, Carrier M (September 2018). "The efficacy and safety of anticoagulation in cerebral vein thrombosis: A systematic review and meta-analysis". Thrombosis Research. 169: 135–139. doi:10.1016/j.thromres.2018.07.023. PMID 30056293. S2CID 51876550.
^ abStam J (2005). "Thrombosis of the cerebral veins and sinuses". N. Engl. J. Med. 352 (17): 1791–8. doi:10.1056/NEJMra042354. PMID 15858188. S2CID 42126852.
^Coutinho JM, Zuurbier SM, Bousser MG, Ji X, Canhão P, Roos YB, Crassard I, Nunes AP, Uyttenboogaart M, Chen J, Emmer BJ, Roosendaal SD, Houdart E, Reekers JA, van den Berg R, de Haan RJ, Majoie CB, Ferro JM, Stam J (1 August 2020). "Effect of Endovascular Treatment With Medical Management vs Standard Care on Severe Cerebral Venous Thrombosis: The TO-ACT Randomized Clinical Trial". JAMA Neurology. 77 (8): 966–973. doi:10.1001/jamaneurol.2020.1022. PMC 7235912. PMID 32421159.
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