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11 - Cerebral venous thrombosis

from Section III - Diagnostics and syndromes

Published online by Cambridge University Press:  05 May 2010

Michael Brainin
Zentrum für Klinische Neurowissenschaften, Donnau-Universität, Krems, Austria
Wolf-Dieter Heiss
Universität zu Köln
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Acute thrombosis of the cerebral sinuses and veins (cerebral venous thrombosis, CVT) is considered to be the cause of an acute stroke in approximately 1% of all stroke patients. However, the incidence of CVT is not known, as population-based studies are lacking. It has been estimated that annually about five to eight cases of CVT are identified among stroke patients of tertiary care hospitals [1]. Historically, CVT was considered a severe, almost inevitably fatal disease, as diagnosis in the pre-angiograph era was usually made post-mortem. However, modern neuroimaging techniques allow the diagnosis of CVT at an early stage and document that CVT is more frequent than was traditionally assumed, and that its prognosis is much better than is generally accepted, provided that the diagnosis is suspected, the respective neuroimaging examinations are performed in a timely manner, and therapy is initiated early, i.e. often with the diagnosis being clinically suspected only. The variety of clinical signs and symptoms renders the diagnosis of CVT a challenge to the physician. Diagnosis is still frequently overlooked or delayed due to the wide spectrum of clinical symptoms and the often subacute or lingering disease onset.

It is important to keep the diagnosis of CVT in mind in stroke cases that present with a fluctuating course, headache, epileptic seizures or disturbances of the level of consciousness. With timely therapeutic intervention, CVT has a favorable prognosis, with an overall mortality rate of about 8% in recent studies [2].

Publisher: Cambridge University Press
Print publication year: 2009

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Einhaupl, K, Bousser, MG, Bruijn, SFTM, et al. Guidelines on the treatment of cerebral venous and sinus thrombosis. Eur J Neurol 2006; 13:553–9.CrossRefGoogle ScholarPubMed
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
Amery, A, Bousser, MG. Cerebral venous thrombosis. Clin Neurol 1992; 19:87–111.CrossRefGoogle Scholar
Stam, J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005; 352:1791–8.CrossRefGoogle ScholarPubMed
Schmiedek, P, Einhaupl, KM, Moser, E. Cerebral blood flow in patients with sinus venous thrombosis. In: Einhaupl, KM, Kempski, O, Baethmann, A, eds. Cerebral Sinus Thrombosis: Experimental and Clinical Aspects. New York: Plenum Press; 1990: 75–83.CrossRefGoogle Scholar
Bruijn, SFTM, Stam, J, for the Cerebral Venous Sinus Thrombosis Study Group. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke 1999; 30:484–8.CrossRefGoogle ScholarPubMed
Cantu, C, Barinagarrementiera, F. Cerebral venous thrombosis associated with pregnancy and puerperium: a review of 67 cases. Stroke 1993; 24:1880–4.CrossRefGoogle ScholarPubMed
Einhaupl, K, Villringer, A, Meister, W, et al. Heparin treatment in sinus venous thrombosis. Lancet 1991; 338:597–600.CrossRefGoogle ScholarPubMed
Bergh, WM, Schaaf, I, Gijn, J. The spectrum of presentations of deep venous infarction caused by deep cerebral vein thrombosis. Neurology 2005; 65:192–6.CrossRefGoogle ScholarPubMed
Renowden, S. Cerebral venous sinus thrombosis. Eur Radiol 2004; 14:215–26.CrossRefGoogle ScholarPubMed
Tsitouridis, I, Papapostolou, P, Rudolf, J, et al. Non-neoplastic dural sinus thrombosis: An MRI and MRV evaluation. Riv Neuroradiologia 2005; 18:581–8.CrossRefGoogle Scholar
Baumgartner, RW, Studer, A, Arnold, M, et al. Recanalization of cerebral venous thrombosis. J Neurol Neurosurgery Psychiatry 2003; 74:459–61.CrossRefGoogle Scholar
Bono, F, Lupo, MR, Lavano, A, et al. Cerebral MR venography of transverse sinuses in subjects with normal CSF pressure. Neurology 2003; 61:1267–70.CrossRefGoogle ScholarPubMed
Bousser, MG, Ferro, J. Cerebral venous thrombosis: an update. Lancet Neurology 2007; 6:162–70.CrossRefGoogle ScholarPubMed
Lalive, PH, Moerloose, P, Lovblad, K, et al. Is measurement of D-dimer useful in the diagnosis of cerebral venous thrombosis?Neurology 2003; 61:1057–60.CrossRefGoogle Scholar
Sacco, RL, Adams, R, Albers, G, et al. Guidelines for the prevention of stroke in patients with ischemic stroke or transient ischemic attack. Stroke 2006; 37:577–617.CrossRefGoogle ScholarPubMed
Stam, J, Bruijn, SFTM, Veber, G. Anticoagulation for cerebral sinus thrombosis. Cochrane Database Syst Rev 2002; 4:CD002005.Google Scholar
Donden, CJJ, Belt, AGM, Prins, HM, et al. Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism. Cochrane Database Syst Rev 2004; 4:CD001100.Google Scholar
Buller, HR, Agnelli, G, Hull, RH, et al. Antithrombotic therapy for venous thromboembolic disease. The seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004; 126:401–28.CrossRefGoogle ScholarPubMed
Canhao, P, Falcao, F, Ferro, JM. Thrombolytics for cerebral sinus thrombosis: a systematic review. Cerebrovasc Dis 2003; 15:159–66.CrossRefGoogle ScholarPubMed
Ciccone, A, Canhao, P, Falcao, F, Ferro, JM, Sterzi, R. Thrombolysis for cerebral vein and dural sinus thrombosis. Stroke 2004; 35:2428.CrossRefGoogle Scholar
Ferro, JM, Correia, M, Rosas, MJ, et al. Seizures in cerebral vein and dural sinus thrombosis. Cerebrovasc Dis 2003; 15:78–83.CrossRefGoogle ScholarPubMed
Canhao, P, Cortesao, 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
Rudolf, J, Hilker, R., Terstegge, K, et al. Extended haemorrhagic infarction following isolated cortical venous thrombosis. Eur Neurol 1999; 41:115–16.CrossRefGoogle Scholar
deVeber, G, Chan, A, Monagle, P, et al. Anticoagulation therapy in pediatric patients with sinovenous thrombosis: a cohort study. Arch Neurol 1998; 55:1533–7.CrossRefGoogle ScholarPubMed
Golomb, MR. Sinovenous thrombosis in neonates. Semin Cerebrovasc Dis Stroke 2001; 1:216–24.CrossRefGoogle Scholar
Ferro, JM, Canhao, P, Bousser, M-G, Barinagarrementeria, F. Cerebral vein and dural sinus thrombosis in elderly patients. Stroke 2005; 36:1927–32.CrossRefGoogle ScholarPubMed

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