A rare localization of cerebral venous sinus thrombosis. Case report

Carangelo, B

doi:10.11138/gchir/2015.36.2.079

Cited by 6 publications

(7 citation statements)

References 24 publications

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“…It is presumed that is due to the elevated pressure in the nerve’s satellite vein provoking transient neurapraxia 6. The progression to bilateral orbital symptoms in the course of septic CST is not common but is reported7 to be pathognomonic for CST, as the two cavernous sinuses are interconnected by the intercavernous sinuses that encircle the pituitary gland. Further extension of infection to adjacent structures may result in visual loss, hypopituitarism, meningeal irritation or true meningitis, brain abscess, epidural and subdural empyemas and finally coma and death.…”

Section: Discussionmentioning

confidence: 99%

Cavernous sinus thrombosis due to ipsilateral sphenoid sinusitis

et al. 2019

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We report a case of septic thrombosis of the right cavernous sinus in a diabetic woman in her late 70’s due to ipsilateral sphenoid sinusitis. The diagnosis was delayed and made only after the abrupt and dramatic appearance of the manifestations of sinus thrombosis. The patient developed, among the other symptoms, right peripheral facial palsy, which is a very rare manifestation in cavernous sinus thrombosis (CST). She was treated with broad-spectrum antibiotics and enoxaparin. The day of the scheduled drainage of sphenoid sinus—24 hours after the initiation of anticoagulation—she developed fatal subarachnoid haemorrhage. Our case demonstrates the difficulty of timely diagnosis of acute sphenoid sinusitis which has emerged as the most common primary infectious source potentially leading in CST. It also underscores the uncertainty concerning the use of anticoagulation in cerebral sinus thrombosis of infectious origin.

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Section: Discussionmentioning

confidence: 99%

Cavernous sinus thrombosis due to ipsilateral sphenoid sinusitis

et al. 2019

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“…The sensitivity and specificity of the attenuated vein sign for the diagnosis of deep venous thrombosis are considered 100% and 99.4% respectively, whereas the sensitivity and specificity of the cord sign for CVT are considered 64.6% and 97.2% respectively [62]. Reduced density of the ischemic focus (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) surrounding the thrombosed vessel improves visualization and detection of the symptom of a hyperdense vessel the density of which is usually 60 -80 HU. In general, pathological manifestations on the native CT (symptoms of a low-density focus and hyperdense vessel) are detected with CVT in about 30% of cases only [63].…”

Section: The Native Ct Of the Brain Is Performed Everywhere Immediate...mentioning

confidence: 99%

“…Headache onset is acute in 51.1%, subacute in 42.6%, thunderclap in 4.3% and chronic in 2.1% [28]. This symptom occurs among patients' complaints in approximately 75-90% of cases [11,29,30]. In 25% of cases headache is the only complaint of the patient; often there is no connection between the localization of the headache and the site of sinus thrombosis [14].…”

Section: Introductionmentioning

confidence: 99%

Clinical and instrumental indicators of intracranial venous stasis and secondary ischemia in cerebral sinus thrombosis. A review

SE¹,

EA²,

IV³

et al. 2021

Med Case Rep Rev

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The purpose of the narrative review is to search for confirmation or controversy of the hypothesis according to which venous ischemia developing in cerebral venous sinustrombosis is secondary as a result of mechanical narrowing of arterioles in the area of vasogenic edema. This review discusses the issues of multimodal radiological diagnosis of a rare disease of a non-hemorrhagic ischemic venous stroke based on expert opinion, current recommendations and our experience. As a result of the review no contradictions to this hypothesis have been found, and the most characteristic symptoms of CVT, secondary ischemia, intracranial venous congestion can be identified in the order of their probable clinical manifestation from patient complaints to the results of instrumental studies: headache, subacute development and course of the disease, papilledema optic disc, increase of central venous pressure, hypodensity of the ischemic foci and hyperdensity signs of sinus on CT, earlier development of vasogenic edema on diffusion MRI, symptoms of stop-contrast and filling defect thrombosed sinuses on contrast enhancement CTA or MRA, dilatation of venous regional collaterals, moderate hyperperfusion on CT-or MR-perfusion, elevated maximum blood flow velocity Rosenthal veins; Galen's vein and rectus sinus, decreased cerebrovascular reactivity index, increased peripheral resistance index on Transcranial Doppler, clot visualization on brachiocephalic veins ultrasound duplex scanning, decreasing of brachiocephalic vessels ultrasound index of arteriovenous ratio.

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“…However, the most common occurrence of severe headache. This symptom occurs among patients' complaints in approximately 75-90% of cases [18][19][20][21]. In 25% of cases, headache is the only complaint of the patient; often, there is no connection between the localization of the headache and the site of sinus thrombosis [7].…”

Section: Introductionmentioning

confidence: 99%

Brachiocephalic Vessels Ultrasound Index of Arteriovenous Ratio (IAVR) and Headache as a Diagnostic Tool for Intracranial Venous Stasis in Arterial/Venous Ischemic Stroke’s Differentiation

Semenov¹,

Elena²,

Alexey³

et al. 2019

J Neuroimaging Psychiatry Neurol

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Identification of signs of intracranial venous stasis using ultrasound methods in combination with determination of headache intensity according to the visual-analogue scale allows us to suspect the venous genesis of ischemic stroke before using neuroimaging methods, which can contribute to the selection of adequate therapy and to improve the prognosis and long-term outcomes of the disease. Objective: To study the prognostic value of a complex of clinical demographic and instrumental indicators for developing a model for early differential diagnosis of ischemic stroke of arterial and venous origin. Material and Methods: Examined 124 patients with ischemic stroke: 22 with venous stroke due cerebral venous sinus thrombosis (VIS), 53.5±16.7y and 102 with atherothrombotic stroke (AIS), 68.3±12.1y which were verified by native CT; CT-angiography, PCT (perfusion CT: CBF, CBV, MTT), brachiocephalic vessels ultrasound index of arteriovenous ratio (IAVR) and transcranial duplex scanning for all. IAVR was obtained due duplex scanning of carotid common arteries (CCA) and internal jugular veins (IJV) according to the formula: V max IJV optimal =2S CCA × Vps CCA/ 3S IJV……… (1) IAVR = max IJV actual / V max IJV optimal × 100%, where……… (2) IAVR-index of arteriovenous ratio, (%) Vps CCA-peak systolic velocity of the CCA, cm/s Vmax IJV-maximum blood flow velocity, cm/s. S-vessel cross-sectional area, cm 2 , as well as. To assess the neurological status of patients, rating scales were used, including a visually analog headache intensity scale. Results: The greatest prognostic significance was possessed by such parameters as the indicator of arteriovenous blood flow ratio and the value of headache intensity on a visual-analogue scale. A model for the differential diagnosis of AIS and VIS, which has high specificity and sensitivity, has been developed. Velocity indicators in the veins of Rosenthal and the vein of Galen are additional signs of intracranial venous stasis.

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A rare localization of cerebral venous sinus thrombosis. Case report

Cited by 6 publications

References 24 publications

Cavernous sinus thrombosis due to ipsilateral sphenoid sinusitis

Cavernous sinus thrombosis due to ipsilateral sphenoid sinusitis

Clinical and instrumental indicators of intracranial venous stasis and secondary ischemia in cerebral sinus thrombosis. A review

Brachiocephalic Vessels Ultrasound Index of Arteriovenous Ratio (IAVR) and Headache as a Diagnostic Tool for Intracranial Venous Stasis in Arterial/Venous Ischemic Stroke’s Differentiation

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