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Clinical Neuroradiology pp 1–29Cite as

Imaging of Cerebral Venous and Sinus Thrombosis

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Abstract

Cerebral venous and sinus thrombosis (CVST) is an important cause of stroke, especially in young patients and children, resulting from clot formation and propagation leading to the occlusion of intracranial venous system components, including the dural sinuses, the cortical veins, and the proximal segment of the jugular veins.

Imaging techniques are essential to establish the diagnosis and prognosis and to monitor treatment efficacy. Endovascular interventional neuroradiological procedures may also be useful for venous recanalization in patients’ refractory to conventional treatments.

Cerebral venous thrombosis may be isolated or associated with a wide spectrum of other vascular disorders with direct impact on their natural history and is characterized by a variability of clinical and imaging presentation. Headache is the most common symptom. Focal neurological syndrome (deficits and seizures), intracranial hypertension syndrome, and encephalopathy are also common clinical manifestations. The imaging diagnosis of CVST includes the demonstration of the thrombus/venous occlusion (direct signs) and the presence of intracranial lesions (indirect signs), such as brain swelling, brain edema, venous infarction, intracranial hemorrhage, and decreased CSF absorption. Imaging also permits the understanding of the main pathophysiological hemodynamic changes induced by the venous thrombosis and to predict the outcome.

Clinical neuroradiology plays a central role in the diagnosis and monitoring of CVST and, by means of endovascular procedures, has a potential role for treatment of the most severe and refractory cases.

This publication is endorsed by: European Society of Neuroradiology (www.esnr.org).

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Abbreviations

ADC:

Apparent diffusion coefficient

BBB:

Blood-brain barrier

CBF:

Cerebral blood flow

CE:

Contrast enhancement

CPP:

Capillary perfusion pressure

CSF:

Cerebrospinal fluid

CT:

Computed tomography

CTV:

Computed tomography venography

CVST:

Cerebral venous and sinus thrombosis

dAVF:

Dural arteriovenous fistula

DSA:

Digital subtraction angiography

DWI:

Diffusion-weighted imaging

FLAIR:

Fluid-attenuated inversion recovery

GRE:

Gradient-recalled echo

HU:

Hounsfield unit

ICA:

Internal carotid artery(ies)

MPR:

Multiplanar reconstructions

MPRAGE:

Magnetization-prepared rapid acquisition gradient-echo

MR:

Magnetic resonance

MRI:

Magnetic resonance imaging

MRV:

Magnetic resonance venography

PC:

Phase-contrast

SS PC:

Single-slice phase-contrast

TOF:

Time-of-flight

VA:

Vertebral artery(ies)

WI:

Weighted Imaging

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Author information

Authors and Affiliations

  1. Head of Neuroradiology, Hospital Beatriz Ângelo, Loures – Lisbon, Portugal

    Pedro Vilela

  2. Diagnostic and Interventional Neuroradiology Graduate Consultant, Hospital da Luz, Lisbon, Portugal

    Pedro Vilela

  3. Hospital Garcia de Orta, Almada, Portugal

    Pedro Vilela

Authors
  1. Pedro Vilela
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Corresponding author

Correspondence to Pedro Vilela .

Editor information

Editors and Affiliations

  1. Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands

    Frederik Barkhof

  2. National Hosp.f Neurology & Neurosurgery, UCL National Hosp.f Neurology & Neurosurgery, London, UK

    Rolf Jager

  3. Division of Neuroradiology, University Hospital Vienna Division of Neuroradiology, Wien, Austria

    Majda Thurnher

  4. Department of Neuroradiology, Hospital Vall d’Hebrón Department of Neuroradiology, Barcelona, Spain

    Alex Rovira Cañellas

Section Editor information

  1. Institut und Poliklinik für Neuroradiologie, Universitätsklinikum Carl Gustav Carus, Dresden, Dresden, Saxonia, Germany

    Rüdiger von Kummer

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Vilela, P. (2019). Imaging of Cerebral Venous and Sinus Thrombosis. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_25-1

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  • DOI: https://doi.org/10.1007/978-3-319-61423-6_25-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61423-6

  • Online ISBN: 978-3-319-61423-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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