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Cerebral Venous Sinus Thrombosis

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Critical Care Neurology and Neurosurgery

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

With the advent and increasing availability of neuroimaging in the past few decades, cerebral venous thrombosis (CVT) has become a more easily recognized disease and appears to be more common than previously believed. Despite this, CVT remains a diagnostic and therapeutic challenge. The true incidence of CVT remains unclear. In the past the diagnosis of CVT was largely made at autopsy, leading many to believe that most cases were fatal. Early series based on angiographic diagnosis estimated mortality to be thirty to fifty percent (1,2). More recent series, however, have estimated mortality at 6–33%. Improvement in magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) techniques have led to an increase in premorbid diagnosis and it has become clear that CVT is more common than previously thought. More recent studies have found death rates ranging between 5 and 30% (3–7). Furthermore, a wide range of disease symptomatology and severity may be present (3,5,8). Although this may make CVT more difficult to diagnose, recent studies suggesting effective therapy underscore the importance of prompt recognition of this elusive, but treatable cause of neurologic deterioration

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References

  1. Bousser M, Russell R. Cerebral Venous Thrombosis, vol 1. London: WB Saunders, 1997.

    Google Scholar 

  2. Krayenbuhl H. Cerebral venous and sinus thrombosis. Clin. Neurosurg. 1967; 14: 1–24.

    Google Scholar 

  3. Ameri A, Bousser M. Cerebral venous thrombosis. Neurol. Clin. 1992; 10: 87–111.

    PubMed  CAS  Google Scholar 

  4. Daif A, Awada A, Al-Rajeh S, Abduljabbar M, et al. Cerebral venous thrombosis in adults: A study of 40 cases from Saudi Arabia. Stroke 1995; 26: 1193–1195.

    Article  PubMed  CAS  Google Scholar 

  5. Bousser M, Chiras J, Bories J, Castaigne P. Cerebral venous thrombosis: A review of 38 cases. Stroke 1985; 16: 199–213.

    Article  PubMed  CAS  Google Scholar 

  6. Thron A, Wessel K, Linden D, Schroth G, Dichgans J. Superior sagittal sinus thrombosis: Neuroradiological evaluation and clinical findings. J. Neurol. 1986; 233: 283–288.

    Article  PubMed  CAS  Google Scholar 

  7. Virapongse C, Cazenave C, Quisling R, Sarwar M, Hunter S. The empty delta sign: Frequency and significance in 76 cases of dural sinus thrombosis. Radiology 1987; 162: 779–785.

    PubMed  CAS  Google Scholar 

  8. Tsai F, Wang A, Matocich V, et al. MR staging of acute dural sinus thrombosis: Correlation with venous pressure measurements and implications for treatment and prognosis. Am. J. Neuroradiol. 1995; 16: 1021–1029.

    PubMed  CAS  Google Scholar 

  9. Mas J, Meder J, Meary E, Bousser M. Magnetic resonance imaging in lateral sinus hypoplasia and thrombosis. Stroke 1990; 21: 1350–1356.

    Article  PubMed  CAS  Google Scholar 

  10. Kaplan H, Browder J. Atresia of the rostral superior sagittal sinus: substitute parasagittal venous channels. J. Neurosurg. 1973; 38: 602–607.

    Article  PubMed  CAS  Google Scholar 

  11. Huber P. Cerebral Angiography. New York: Thieme, 2001.

    Google Scholar 

  12. Meder J, Chiras J, Roland J, Guinet P, Bracard S, Bargy F. Venous territories of the brain. J. Neuroradiol. 1994; 21: 118–133.

    PubMed  CAS  Google Scholar 

  13. Biousse V, Bousser M. Cerebral venous thrombosis. Neurologist 1999; 5: 326–349.

    Article  Google Scholar 

  14. Tehindrazanarivelo A, Evard S, Schaison M, Mas J-L, Dormaont D, Bousser M. Prospective study of cerebral sinus thrombosis in patients presenting with benign intracranial hypertension. Cerebrovasc. Dis. 1992; 2: 22–27.

    Article  Google Scholar 

  15. Southwick F, Richardson EJ, Swartz M. Septic thrombosis of the dural venous sinuses. Medicine 1986; 65: 82–106.

    Article  PubMed  CAS  Google Scholar 

  16. Lew D, Southwick F, Montgomery W, Weber A, Baker A. Sphenoid sinusitis. A review of 30 cases. N. Engl. J. Med. 1983; 309: 1149–1154.

    Article  PubMed  CAS  Google Scholar 

  17. DiNubile M. Septic thrombosis of the cavernous sinuses. Arch. Neurol. 1988; 45: 567–572.

    Article  PubMed  CAS  Google Scholar 

  18. Baumgartner R, Landis T. Venous thalamic infarction. Cerebrovasc. Dis. 1992; 2: 353–358.

    Article  Google Scholar 

  19. Haley E, Brashear H, Barth J, Cail W, Kassell N. Deep cerebral venous thrombosis: Clinical, neuroradiological, and neuropsychological correlates. Arch. Neurol. 1989; 46: 337–340.

    Article  PubMed  Google Scholar 

  20. Ur Rahman N, Al Tahan A. Computed tomographic evidence of an extensive thrombosis and infarction of the deep venous system. Stroke 1993; 24: 744–746.

    Article  PubMed  CAS  Google Scholar 

  21. Cantu C, Barinagarrementeria F. Cerebral venous thrombosis associated with pregnancy and puerperium. Review of 67 cases. Stroke 1993; 24: 1880–1884.

    Article  PubMed  CAS  Google Scholar 

  22. Villringer A, Mehraein S, Einhaupl K. Pathophysiological aspects fo cerebral sinus venous thrombosis (SVT). J. Neuroradiol. 1994; 21: 72–80.

    PubMed  CAS  Google Scholar 

  23. Bousser M, Kittner S. Oral contraceptives and stroke. Cephalalgia 2000; 20: 183–189.

    Article  PubMed  CAS  Google Scholar 

  24. Lanska D, Kryscio R. Stroke and intracranial venous thrombosis during pregnancy and puerperium. Neurology 1998; 51: 1622–1628.

    Article  PubMed  CAS  Google Scholar 

  25. Srinivasan K. Cerebral venous and arterial thrombosis in pregnancy and the puerperium. A study of 135 patients. Angiology 183; 34: 731–746.

    Google Scholar 

  26. Mas J, Lamy C. Stroke in pregnancy and the puerperium. J. Neurol. 1998; 245: 305–313.

    Article  PubMed  CAS  Google Scholar 

  27. Wilder-Smith E, Kothbauere-Margreiter I, Lammle B, Sturzenegger M, Ozdoba C, Hauser S. Dural puncture and activated protein C resistance: risk factors for cerebral venous sinus thrombosis. J. Neurol. Neurosurg. Psychiatry 1997; 63: 351–356.

    Article  PubMed  CAS  Google Scholar 

  28. Jaillard A, Hommel M, Mallaret M. Venous sinus thrombosis associated with androgens in a healthy young man. Stroke 1994; 25: 212–213.

    Article  PubMed  CAS  Google Scholar 

  29. Shiozawa Z, Yamada H, Mabuchi C, Hotta T, Saito M, Sobue I et al. Superior sagittal sinus thrombosis associated with androgen therapy for hypoplastic anemia. Ann. Neurol. 1982; 12: 578–580.

    Article  PubMed  CAS  Google Scholar 

  30. Crawford J, Cotran R. The pancreas. In: Cotran R, Kumar V, Collins T, eds. Pathologic Basis of Disease. Philadelphia: WB Saunders, 2001: 902–929.

    Google Scholar 

  31. Hickey W, Garnick M, Henderson I, Dawson D. Primary cerebral venous thrombosis in patients with cancer—a rarely diagnosed paraneoplastic syndrome. Report of three cases and review of the literature. Am. J. Med. 1982; 73: 740–750.

    Article  PubMed  CAS  Google Scholar 

  32. Zuber M, Toulon P, Marnet L, Mas J. Factor V leiden mutation in cerebral venous thrombosis. Stroke 1996; 27: 1721–1723.

    Article  PubMed  CAS  Google Scholar 

  33. Martinelli I, Landi G, Merati G, Cella R, Tosetto A, Mannucci P. Factor V gene mutation is a risk factor for cerebral venous thrombosis. Thromb. Haemost. 996;75:393–394.

    Google Scholar 

  34. Martinelli I, Sacchi E, Landi G, Taioli E, Duca F, Mannucci P. High risk of cerebral vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N. Engl. J. Med. 1998; 338: 1793–1797.

    Article  PubMed  CAS  Google Scholar 

  35. Lau S, Tkachuck M, Hasegawa D, Edson J. Plasminogen and antithrombin III deficiencies in the childhood nephrotic syndrome associated with plasminogenuria and antithrombinuria. J. Pediatr. 1980; 96: 390–392.

    Article  PubMed  CAS  Google Scholar 

  36. Lau S, Bock G, Edson J, Michael A. Sagittal sinus thrombosis in the nephrotic syndrome. J. Pediatr. 1980; 97: 948–950.

    Article  PubMed  CAS  Google Scholar 

  37. Markowitz R, Ment L, Gryboski J. Cerebral thromboembolic disease in pediatric and adult inflammatory disease: case report and review of the literature. J. Pediatr. Gastroenterol. Nutr. 1989; 8: 413–420.

    Article  PubMed  CAS  Google Scholar 

  38. Vidaihet M, Piette J, Wechsler B, Bousser M, Brunet P. Cerebral venous thrombosis in systemic lupus erythematosus. Stroke 1990; 21: 1226–1231.

    Article  Google Scholar 

  39. Laversuch C, Brown M, Clifton A, Bourke B. Cerebral venous thrombosis and acquired protein S deficiency: an uncommon cause of headache in systemic lupus erythematous. Br. J. Rheumatol. 1995; 34: 572–575.

    Article  PubMed  CAS  Google Scholar 

  40. Carhuapoma J, Mitsias P, Levine S. Cerebral venous thrombosis and anticardiolipin antibodies. Stroke 1997; 28: 2363–2369.

    Article  PubMed  CAS  Google Scholar 

  41. Sakane T, Takeno M, Suzuki N, Inaba G. Behcet’s disease. N. Engl. J. Med. 1999; 341: 1284–1291.

    Article  PubMed  CAS  Google Scholar 

  42. Aidi S, Chaunu M, Biousse V, Bousser M. Changing pattern of headache pointing to cerebral venous thrombosis after lumbar puncture and intravenous high-dose corticosteriods. Headache 1999; 39: 559–564.

    Article  PubMed  CAS  Google Scholar 

  43. Stocks G, Wooller D, Young J, Fernando R. Postpartum headache after epidural blood patch: investigation and diagnosis. Br. J. Anesth. 2000; 85: 498–499.

    Google Scholar 

  44. Newman D, Levine S, Curtis V, Welch K. Migraine-like visual phenomena associated with cerebral venous thrombosis. Headache 1989; 29: 82–85.

    Article  PubMed  CAS  Google Scholar 

  45. Purvin V, Trobe J, Kosmorsky G. Neuro-opthalmic features of cerebral venous obstruction. Arch. Neurol. 1995; 52: 880–885.

    Article  PubMed  CAS  Google Scholar 

  46. Caplan L. Posterior Circulation Disease: Clinical Findings, Diagnosis, and Management. Cambridge, MA: Blackwell Science, 1996.

    Google Scholar 

  47. Kuehnen J, Schwartz A, Neff W, Hennerici M. Cranial nerve syndrome in thrombosis of the transverse/sigmoid sinuses. Brain 1998; 121: 381–388.

    Article  PubMed  Google Scholar 

  48. Bouonanno F, Moody D, Ball M, Laster D. Computed cranial tomographic findings in cerebral sino-venous occlusion. J. Comput. Assist. Tomogr. 1978; 2: 281–290.

    Article  Google Scholar 

  49. Patronas N, Duda E, Mirfakhraee M, Wollmann R. Superior sagittal sinus thrombosis diagnosed by computed tomography. Surg. Neurol. 1981; 15: 163–170.

    Google Scholar 

  50. Kim D, Walczak T. Computed tomography of deep cerebral venous thrombosis due to high-altitude polycythemia: Case report. J. Comput. Assist. Tomogr 1986; 10: 148–150.

    Google Scholar 

  51. Zilkha A, Stenzler S, Lin J. Computed tomography of the normal and abnormal superior sagittal sinus. Clin. Radiol. 1982; 33: 415–425.

    Article  PubMed  CAS  Google Scholar 

  52. Brant-Zawadzki M, Chang G, McCarty G. Computed tomography in dural sinus thrombosis. Arch. Neurol. 1982; 39: 446–447.

    Article  PubMed  CAS  Google Scholar 

  53. Casey S, Alberico R, Patel M, Jimenez J, Ozsvath R, Maguire W et al. Cerebral CT venography. Radiology 1996; 198: 163–170.

    PubMed  CAS  Google Scholar 

  54. Wetzel S, Kirsch E, Stock K, Kolbe M, Kaim A, Radue E. Cerebral vein: comparative study of CT venography with intraarterial digital subtraction angiography. Am. J. Neuroradiol. 1999; 20: 249–255.

    PubMed  CAS  Google Scholar 

  55. Mas J, Meder J, Meary E, Bousser M. Magnetic resonance imaging in lateral sinus hypoplasia and thrombosis. Stroke 1990; 21: 1350–1356.

    Article  PubMed  CAS  Google Scholar 

  56. Perkin G. Cerebral venous thrombosis: developments in imaging and treatment. J. Neurol. Neurosurg. Psychiatry 1995; 59: 1–3.

    Article  PubMed  CAS  Google Scholar 

  57. Valdueza J, Hoffmann O, Weih M, Mehraein S, Einhaupl K. Monitoring of venous hemodynamics in patients with cerebral thrombosis by transcranial doppler ultrasound. Arch. Neurol. 1995; 56: 229–234.

    Article  Google Scholar 

  58. Valdueza JM, Harms L, Doepp F, Koscielny J, Einhaupl KM. Venous microembolic signals detected in patients with cerebral sinus thrombosis. Stroke 1997; 28: 1607–1609.

    Article  PubMed  CAS  Google Scholar 

  59. Osborn A. Stroke. Diagnostic Neuroradiology. St. Louis: Mosby, 1994: 330–400.

    Google Scholar 

  60. Brucker M, Vollert-Rogenhofer H, Wagner M, et al. Heparin treatment in acute cerebral sinus venous thrombosis: a retrospective clinical an MR analysis of 42 cases. Cerebrovasc. Dis. 1998; 8: 331–333.

    Article  PubMed  CAS  Google Scholar 

  61. Einhaupl K, Masuhr F. Cerebral venous and sinus thrombosis: an update. Eur. J. Neurol. 1994; 1: 109–126.

    Article  Google Scholar 

  62. Einhaupl K, Villringer A, Meister W, Mehracin S, Garner C, Pelkofer M et al. Heparin treatment in sinus venous thrombosis. Lancet 1991; 338: 597–600.

    Article  PubMed  CAS  Google Scholar 

  63. Stam J, Lensing A, Vermeulen M, Tijssen J. Heparin treatment in sinus venous thrombosis. Lancet 1991; 338: 1154.

    Article  PubMed  CAS  Google Scholar 

  64. de Bruijn S, Stam J, for the Cerebral Venous Sinus Thrombosis Study Group. Randomized, placebo controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral venous thrombosis. Stroke 1999; 30: 484–488.

    Article  PubMed  Google Scholar 

  65. Bousser M. Cerebral venous thrombosis: nothing, heparin or local thrombolysis. Stroke 1999; 30: 481–483.

    Article  PubMed  CAS  Google Scholar 

  66. Frey J, Muro G, McDougall C, Dean B, Jahnke H. Cerebral venous thrombosis: combined intrathrombus rtPA and intravenous heparin. Stroke 1999; 30: 489–494.

    Article  PubMed  CAS  Google Scholar 

  67. Diaz J, Schiffman J, Urban E, Maccario M. Superior sagittal thrombosis and pulmonary embolism: a syndrome rediscovered. Acta. Neurol. Scand. 1992; 86: 390–396.

    Article  PubMed  CAS  Google Scholar 

  68. Houser O, Campbell J, Campbell R, Sundt T. Arteriovenous malformation affecting the transverse dural venous sinus. An acquired lesion. Mayo Clin. Proc. 1979; 54: 651–661.

    PubMed  CAS  Google Scholar 

  69. Kalbag R, Woollf A. Cerebral Venous Thrombosis, vol 1. London: Oxford University Press, 1967.

    Google Scholar 

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Authors
  1. Zeyad Marcos
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  2. Sophia Sundararajan
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Editors and Affiliations

  1. Neurosciences Critical Care, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA

    Jose I. Suarez MD

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Marcos, Z., Sundararajan, S. (2004). Cerebral Venous Sinus Thrombosis. In: Suarez, J.I. (eds) Critical Care Neurology and Neurosurgery. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-660-7_21

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  • DOI: https://doi.org/10.1007/978-1-59259-660-7_21

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-350-3

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