Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Goyal, Gourav; Charan, A; Singh, Rambir

doi:10.4103/aian.aian_470_17

Cited by 19 publications

(25 citation statements)

References 22 publications

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“…MRI and MRV were also the two most common imaging modalities used for diagnosis or confirmation of CVST. Therefore, MRV, in combination with MRI, is a non-invasive, specific modality that has proven reliable in diagnosing CVST [42][43].…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis in Adults with Prothrombotic Conditions: A Systematic Review and a Case from Our Institution

Komro¹,

Findakly

2020

Cureus

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Cerebral venous sinus thrombosis (CVST) is a rare condition characterized by elevated intracranial pressure due to impaired cerebral venous drainage, potentially leading to life-threatening consequences. We searched the PubMed electronic database for 'cerebral venous sinus thrombosis' and 'prothrombotic' cases reported in adults (19+ years) and conducted a systematic review for the published literature in the English language pooled with a case from our institution. Data were analyzed regarding patient demographics, risk factors, clinical features, treatment modalities, and outcomes when available.Thirty cases of CVST were identified (29 case reports, of whom two were described in a case series, and the one case from our institution). The patients' mean age was 39 years (range: 19 -65). The male: female ratio was 1.14:1. The majority (73.3%) had at least one preexisting risk factor, with prescription drug use being the most common risk factor (33.3%) shared among all patients. Most patients (83.3%) presented with at least two symptoms. The most common presenting symptoms were headache (70%), gastrointestinal disturbance (50%), and seizures (40%). Focal deficits (36.7%), vision disturbances (30%), and altered consciousness (20%) were the remaining presenting complaints. Twelve cases (40%) commented on papilledema, with 10 (83.3%) having papilledema present. Anticoagulation abnormalities were examined in 26 cases (86.7%), out of which four cases (15.4%) had isolated protein S (PS) deficiency, three cases (11.5%) had isolated antithrombin III (ATIII) deficiency, and one case (3.8%) had isolated protein C (PC) deficiency. The most common initial imaging modality (22 cases, 73.3%), and most commonly used overall (23 cases, 76.7%), was computed tomography (CT). Magnetic resonance imaging (MRI) was the second most common imaging modality for initial use (five cases, 16.7%), diagnosis or confirmation of CVST (eight cases, 26.7%), and overall (21 cases, 70%). Heparin treatment was involved in the treatment of 18 cases (60%), and warfarin treatment was used in 10 cases (33.3%). Heparin-warfarin combination treatment was utilized in eight cases (26.7%). Most patients survived (28 cases, 93.3%), while the two remaining patients died secondary to brain death from the CVST (6.7%).The findings from this study highlight the clinical characteristics of CVST. Therefore, this study aims to increase awareness of this rare entity. Physicians should maintain a high index of suspicion in order to diagnose patients presenting in the proper clinical context, given this case shares various forms of presentations with other common clinical conditions but requires long-term anticoagulation.

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Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis in Adults with Prothrombotic Conditions: A Systematic Review and a Case from Our Institution

Komro¹,

Findakly

2020

Cureus

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“…4,[6][7][8] DVST are typically asymptomatic, however, may present with headaches, seizures, altered sensorium, and neurologic deficits. 4,9 The vague symptoms often complicate and delay diagnosis. 10 If DVST is suspected postoperatively, proper imaging in the way of magnetic resonance imaging (MRI), MR venography, or computed tomography (CT) venogram is typically performed.…”

Section: Introductionmentioning

confidence: 99%

Dural Venous Sinus Thrombosis after Vestibular Schwannoma Surgery: The Anticoagulation Dilemma

Brahimaj

Beer‐Furlan

Crawford

et al. 2019

J Neurol Surg B Skull Base

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Introduction Dural venous sinus thrombosis (DVST) is a relatively understudied complication of vestibular schwannoma (VS) surgery. Several studies have examined this topic; however, there is limited data on the incidence, clinical progression, and proper management of this patient population. Methods A retrospective review was performed for patients undergoing surgery for VS at a single institution. All postoperative imaging was reviewed for incidence of DVST. Demographic data were collected including tumor and surgical characteristics along with postoperative course. Results A total of 63 patients underwent resection of their VS. The incidence of DVST was 34.9%. The operative time was greater in the dural venous sinus thrombosis (DSVT) group, at an average of 6.69 hours versus 4.87 in the no DSVT cohort (p = 0.04). Tumor size was correlationally significant (p = 0.051) at 2.75 versus 2.12 cm greatest diameter. The translabyrinthine approach was most prevalent (68.2%). The side of the thrombosis was ipsilateral to the tumor and surgery in all patients. The sigmoid sinus was most commonly involved (95.5%). Of them, 85% patients had a codominant or thrombus contralateral to the dominant sinus. All patients were asymptomatic. No patients were treated with anticoagulation. Resolution of thrombus was seen in five (22.7%) of the patients on last follow-up imaging. There were no hemorrhagic complications. Conclusion The overall incidence of DVST was (34.9%) of 63 patients who underwent VS surgery. All patients were asymptomatic and none were treated with anticoagulation. In our study, continuing to observe asymptomatic patients did not lead to any adverse events.

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“…Cerebral Venous Thrombosis(CVT) was once considered as a rare cause of Stroke, but with recent advances in Imaging Technology and awareness of the disease, diagnosis has been made easy. 1 Contrary to Arterial Stroke, Cerebral venous Sinus Thrombosis is commonly seen in young adults and accounts for almost 0.5% of all strokes. 2 Patients with CVT most commonly present with headache, seizures, vomiting, visual disturbances, loss of consciousness and sometimes with neurological deficits.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Venous Thrombosis – Clinical Profile and Role of MRI in Diagnosis and Prognosis

Sandhya¹,

Jaiganesh²,

Rajasekhar³

2019

IJCMSR

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Inclusion Criteria All patients with Cerebral venous sinus/Cortical vein thrombosis confirmed by MRI. Exclusion Criteria Patients with normal Dural Sinuses/Cortical veins on MRI. Patients with MRI Incompatible Devices such as Cochlear Implants, Cardiac Pacemaker etc. Claustrophobic Patients. Proper Consent to include in the study was obtained from all the patients. The study was conducted after considering and following all the factors of Declaration of Helsinki. RESULTS Wide range of age groups were affected by cerebral venous thrombosis in our study from 2 nd decade to 7 th decade in A B S T R A C T Introduction: Cerebral Venous Thrombosis (CVT) is relatively a rare cause of stroke which is potentially treatable without any permanent neurological deficit if diagnosed early in time. The objective of this study was to describe the etiologies, clinical features and the importance of MRI in diagnosis and prognosis of Cerebral Venous Thrombosis. Material and Methods: This was a prospective study done in 50 consecutive patients diagnosed with cerebral venous thrombosis on MRI in Meenakshi Medical College Hospital and Research Institute, Kanchipuram between April 2016 and March 2018. Detailed history, proper clinical examination and necessary laboratory investigations were done in all the cases. Results: Among 50 patients, most of the cases were seen in 21-50 years of age comprising 92%. The most common presenting symptom was headache(82%) followed by Vomiting(52%), altered sensorium(44%) and seizures(42%). Superior sagittal sinus is the commonest one involved in our study. MRI is helpful to assess the prognosis. Venous infarct is seen in 48% of the cases and diffusion restriction is seen only in 8% of cases. Conclusion: Clinical presentation of Cerebral venous thrombosis(CVT) is vague and high degree of clinical suspicion should be there in young patients presenting with headache, seizures or papilledema. MRI plays a very vital role in the diagnosis and prognosis. Heparin, anticoagulants, antiepileptics and symptomatic treatment play the key role in management. Cerebral venous Thrombosis has very good prognosis provided early diagnosis is made and proper treatment started in time.

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Clinical presentation, neuroimaging findings, and predictors of brain parenchymal lesions in cerebral vein and dural sinus thrombosis: A retrospective study

Cited by 19 publications

References 22 publications

Cerebral Venous Sinus Thrombosis in Adults with Prothrombotic Conditions: A Systematic Review and a Case from Our Institution

Cerebral Venous Sinus Thrombosis in Adults with Prothrombotic Conditions: A Systematic Review and a Case from Our Institution

Dural Venous Sinus Thrombosis after Vestibular Schwannoma Surgery: The Anticoagulation Dilemma

Cerebral Venous Thrombosis – Clinical Profile and Role of MRI in Diagnosis and Prognosis

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