Cerebral Venous Thrombosis

  • Rohit Bhatia
  • Bhavna Kaul
  • Deepa Dash


Cerebral venous thrombosis (CVT) was first recognized in the early nineteenth century when Ribes, in 1825, described the clinical and autopsy spectrum of superior sagittal sinus thrombosis in a 45-year-old man suffering from a disseminated malignancy [1]. CVT is an important cause of stroke, with diverse clinical features, predisposing factors, brain imaging findings and outcomes. Many cases may remain clinically undetected in view of the variable clinical signs and a generally good prognosis.


  1. 1.
    Ribes MF. Des recherches faites sur la phlebite Revue Medical. Francais et Etrangere er Journal de Clinique del ’Hotel Dieu et de la Charite de Paris. 1825;3:5.Google Scholar
  2. 2.
    Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007;6:162–70.CrossRefGoogle Scholar
  3. 3.
    Wasay M, Kaul S, Menon B. Ischemic stroke in young Asian women: risk factors, subtypes and outcome. Cerebrovasc Dis. 2010;30:418–22.CrossRefGoogle Scholar
  4. 4.
    Banerjee AK, Varma M, Vasista RK, et al. Cerebrovascular disease in north-west India: a study of necropsy material. J Neurol Neurosurg Psychiatry. 1989;52:512–5.CrossRefGoogle Scholar
  5. 5.
    Panagariya A, Maru A. Cerebral venous thrombosis in pregnancy and puerperium—a prospective study. J Assoc Physicians India. 1997;45:857–9.PubMedGoogle Scholar
  6. 6.
    Bousser MG, Russell RR. Cerebral venous thrombosis. London: WB Saunders; 1997.Google Scholar
  7. 7.
    Southwick FS, Richardson EP Jr, Swartz MN. Septic thrombosis of the dural venous sinuses. Medicine (Baltimore). 1986;65:82–106.CrossRefGoogle Scholar
  8. 8.
    Ameri A, Bousser MG. Cerebral venous thrombosis. Neurol Clin. 1992;10:87–111.CrossRefGoogle Scholar
  9. 9.
    de Bruijn SF, Stam J, Koopman MM, et al. Case–control study of risk of cerebral sinus thrombosis in oral contraceptive users who are cautious of hereditary prothrombotic conditions. BMJ. 1998;316:589–92.CrossRefGoogle Scholar
  10. 10.
    Kellett MW, Martin PJ, Enevoldson TP, et al. Cerebral venous sinus thrombosis connected with 20210, a mutation of the prothanbil gene. J Neurol Neurosurg Psychiatry. 1998;65:611–2.CrossRefGoogle Scholar
  11. 11.
    Ferro JM, Canhao P, Stam J, et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–70.CrossRefGoogle Scholar
  12. 12.
    Provenzale JM, Joseph GJ, Barboriak DP. Dural sinus thrombosis: findings on CT and MR imaging and diagnostic pitfalls. AJR Am J Roentgenol. 1998;170:777–83.CrossRefGoogle Scholar
  13. 13.
    Rivkin MA, Saraiya PV, Woodrow SI. Sinovenous thrombosis associated with skull fracture in the setting of blunt head trauma. Acta Neurochir (Wien). 2014 May;156(5):999–1007.CrossRefGoogle Scholar
  14. 14.
    Silvis SM, Middeldorp S, Zuurbier SM, Cannegieter SC, Coutinho JM. Risk factors for cerebral venous thrombosis. Semin Thromb Hemost. 2016;42:622–31.CrossRefGoogle Scholar
  15. 15.
    de Bruijn SF, Stam J, Kapelle LJ. Thunderclap headache as first symptom of cerebral venous sinus thrombosis. CVST Study Group. Lancet. 1996;348:1623–5.CrossRefGoogle Scholar
  16. 16.
    Bansal H, Chaudhary A, Mahajan A, Paul B. Acute subdural hematoma secondary to cerebral venous sinus thrombosis: case report and review of literature. Asian J Neurosurg. 2016;11(2):177.CrossRefGoogle Scholar
  17. 17.
    Linn J, Pfefferkorn T, Ivanicova K, et al. Non-contrast CT in deep cerebral venous thrombosis and sinus thrombosis: comparison of its diagnostic value for both entities. AJNR Am J Neuroradiol. 2009;30:728–35.CrossRefGoogle Scholar
  18. 18.
    Boukobza M, Crassard I, Bousser MG, Chabriat H. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases. Neuroradiology. 2016;58(1):11–6.CrossRefGoogle Scholar
  19. 19.
    Poon CS, Chang J-K, Swarnkar A, et al. Radiologic diagnosis of cerebral venous thrombosis: pictorial review. AJR Am J Roentgenol. 2007;189:S64–75.CrossRefGoogle Scholar
  20. 20.
    Gaikwad AB, Mudalgi BA, Patankar KB, et al. Diagnostic role of 64-slice multidetector row CT scan and CT venogram in cases of cerebral venous thrombosis. Emerg Radiol. 2008;15:325–33.CrossRefGoogle Scholar
  21. 21.
    Lee SK, ter Brugge KG. Cerebral venous sinus thrombosis in adults—the role of imaging evaluation and management. Neuroimag Clin North Am. 2003;13:139–52.CrossRefGoogle Scholar
  22. 22.
    Strandvik GF. Hypertonic saline in critical care: a review of the literature and guidelines for use in hypotensive states and raised intracranial pressure. Anaesthesia. 2009;64:990–1003.CrossRefGoogle Scholar
  23. 23.
    Canhaõ P, Cortesaõ A, Cabral M, et al. Are steroids useful for the treatment of cerebral venous thrombosis? ISCVT results. Cerebrovasc Dis. 2004;17(Suppl 5):16.Google Scholar
  24. 24.
    Stefini R, Latronico N, Cornali C, et al. Emergent decompressive craniectomy in patients with fixed dilated pupils due to cerebral venous and dural sinus thrombosis: report of three cases. Neurosurgery. 1999;45:626–9.CrossRefGoogle Scholar
  25. 25.
    Villringer A, Mehraein S, Einhaüpl KM. Pathophysiological aspects of cerebral sinus venous thrombosis. J Neuroradiol. 1994;21:72–80.PubMedGoogle Scholar
  26. 26.
    Raza E, Shamim MS, Wadiwala MF, Ahmed B, Kamal AK. Decompressive surgery for malignant cerebral venous sinus thrombosis: a retrospective case series from Pakistan and comparative literature review. J Stroke Cerebrovasc Dis. 2014;23(1):e13–22.CrossRefGoogle Scholar
  27. 27.
    Ferro JM, Correia M, Rosas MJ, et al. Cerebral Venous Thrombosis Portuguese Collaborative Study Group. Seizures in cerebral vein and dural sinus thrombosis. Cerebrovasc Dis. 2003;15:78–83.CrossRefGoogle Scholar
  28. 28.
    Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352:1791–8.CrossRefGoogle Scholar
  29. 29.
    Einhaupl KM, Villringer A, Meister W, et al. Heparin treatment in sinus venous thrombosis. Lancet. 1991;338:597–600.CrossRefGoogle Scholar
  30. 30.
    Benamer HT, Bone I. Cerebral venous thrombosis: anticoagulants or thrombolyic therapy. J Neurol Neurosurg Psychiatry. 2000;69:427–30.CrossRefGoogle Scholar
  31. 31.
    De Bruijn SF, Stam J. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular weight heparin for cerebral sinus thrombosis. Stroke. 1999;30:484–8.CrossRefGoogle Scholar
  32. 32.
    Coutinho JM, Ferro JM, Canhão P, et al. Unfractionated or low-molecular weight heparin for the treatment of cerebral venous thrombosis. Stroke. 2010;41:2575–80.CrossRefGoogle Scholar
  33. 33.
    Einhaupl K, Stamb J, Bousser MG, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol. 2010;17:1229–35.CrossRefGoogle Scholar
  34. 34.
  35. 35.
    Scott JA, Pascuzzi RM, Hall PV, et al. Treatment of dural sinus thrombosis with local urokinase infusion. Case report. J Neurosurg. 1988;68:284–7.CrossRefGoogle Scholar
  36. 36.
    Canhão P, Falcao F, Ferro JM. Thrombolytics for cerebral venous thrombosis: a systematic review. Cerebrovasc Dis. 2003;15:159–66.CrossRefGoogle Scholar
  37. 37.
    Kumar S, Rajshekher G, Reddy CR, et al. Intrasinus thrombolysis in cerebral venous sinus thrombosis: single-center experience in 19 patients. Neurol India. 2010;58:225–9.CrossRefGoogle Scholar
  38. 38.
    Dentali F, Squizzato A, Gianni M, et al. Safety of thrombolysis in cerebral venous thrombosis. A systematic review of the literature. Thromb Haemost. 2010;104:1055–62.CrossRefGoogle Scholar
  39. 39.
    Haghighi AB, Mahmoodi M, Edgell RC, Cruz-Flores S, Ghanaati H, Jamshidi M, et al. Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review. Clin Appl Thromb Hemost. 2013;20:507–15.CrossRefGoogle Scholar
  40. 40.
    Canhão P, Ferro JM, Lindgren AG. Causes and predictors of death in cerebral venous thrombosis. Stroke. 2005;36:1720–5.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Rohit Bhatia
    • 1
  • Bhavna Kaul
    • 1
  • Deepa Dash
    • 1
  1. 1.Department of NeurologyAll India Institute of Medical SciencesNew DelhiIndia

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