Obstructive Hydrocephalus from Venous Sinus Thrombosis

Mullen, Michael T.; Sansing, Lauren H; Hurst, Robert W.; Weigele, John B.; Polasani, Rajeev S.; Messé, Steven R.

doi:10.1007/s12028-008-9108-5

Cited by 8 publications

(7 citation statements)

References 7 publications

(13 reference statements)

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“…Thus, special measures should be undertaken in the form of therapeutic lumbar punctures, acetazolamide administration, external ventricular drainage, or CSF shunt insertion. 53 Decompressive craniectomy should be considered in patients with CVST whose condition deteriorates due to large intracerebral hemorrhages. 25,28,51 There are not sufficient data justifying the employment of craniectomy in these patients, and further research is necessary for outlining the role of this procedure.…”

Section: Treatmentmentioning

confidence: 99%

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

Filippidis¹,

Kapsalaki

Patramani

et al. 2009

FOC

115

160

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Cerebral venous sinus thrombosis (CVST) is a rare clinicopathological entity. The incidence of CVST in children and neonates has been reported to be as high as 7 cases per million people, whereas in adults the incidence is 3–4 cases per million. The predisposing factors to this condition are mainly genetic and acquired prothrombotic states and infection. The clinical picture of CVST is nonspecific, highly variable, and can mimic several other clinical conditions. Diagnosis of CVST is established with the implementation of neuroimaging studies, especially MR imaging and venography. Identification and elimination of the underlying cause, anticoagulation, proper management of intracranial hypertension, and anticonvulsant prophylaxis constitute cornerstones of CVST treatment. Newer treatment strategies such as endovascular thrombolysis and decompressive craniectomy have been recently used in the treatment of patients with CVST with variable success rates. Further clinical research must be performed to delineate the exact role of these newer treatments in the management of severe cases of CVST. The recent advances in the diagnosis and treatment of patients with CVST have significantly lowered the associated mortality and morbidity and have improved the outcome of these patients.

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Section: Treatmentmentioning

confidence: 99%

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

Filippidis¹,

Kapsalaki

Patramani

et al. 2009

FOC

115

160

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“…Acute obstructive hydrocephalus is rare in acute CVT [10,11,12]. Hydrocephalus can have several pathophysiological mechanisms including concomitant meningitis, intraventricular bleeding, compression or distortion of the ventricular system by space-occupying hemispheric or cerebellar venous infarcts and hemorrhages.…”

Section: Discussionmentioning

confidence: 99%

Shunting in Acute Cerebral Venous Thrombosis: A Systematic Review

et al. 2013

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Background and Purpose: The efficacy of cerebrospinal fluid shunting to reduce intracranial hypertension and prevent fatal brain herniation in acute cerebral venous thrombosis (CVT) is unknown. Method: From the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) and a systematic literature review, we retrieved acute CVT patients treated only with shunting (external ventricular drain, ventriculoperitoneal or ventriculojugular shunt). Outcome was classified at 6 months and final follow-up by the modified Rankin Scale (mRS). Results: 15 patients were collected (9 from the ISCVT and 6 from the review) who were treated with a shunt (external ventricular drain in 6 patients, a ventriculoperitoneal shunt in 8 patients or an unspecified type of shunt in another one). Eight patients (53.3%) regained independence (mRS 0-2), while 2 patients (13.3%) were left with a severe handicap (mRS 4-6) and 4 (26.7%) died despite treatment. Five patients with parenchymal lesions were shunted within 48 h from admission deterioration, 4 with an external ventricular drain: 2 (40%) recovered to independence, 2 (40%) had a severe handicap and 1 (20%) died. In contrast, all 3 patients with intracranial hypertension and no parenchymal lesions receiving a ventriculoperitoneal shunt later than 48 h regained independence. Conclusion and Implications: A quarter of acute CVT patients treated with a shunt died, and only half regained independence. With the limitation of the small number of subjects, this review suggests that shunting does not appear to be effective in preventing death from brain herniation in acute CVT. We cannot exclude that shunting may benefit patients with sustained intracranial hypertension and no parenchymal lesions.

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“…[1] The mechanism of hydrocephalus is considered to be secondary to an increase in venous pressure resulting in the blockade of cerebrospinal fluid flow into the sinuses by arachnoid villi. [3] Most of the patients with cerebral venous thrombosis have an increased intracranial pressure without an increase in ventricular size. [45] Why some patients develop hydrocephalus is not clearly understood and only a few adult cases were described.…”

Section: Discussionmentioning

confidence: 99%

“…[45] Why some patients develop hydrocephalus is not clearly understood and only a few adult cases were described. [3]…”

Section: Discussionmentioning

confidence: 99%

Obstructive hydrocephalus resulting from cerebral venous thrombosis

et al. 2011

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Obstructive Hydrocephalus from Venous Sinus Thrombosis

Abstract: Hydrocephalus is a rare complication of cerebral venous sinus thrombosis. Treatment of hydrocephalus with an EVD may not be necessary if interventions are undertaken to urgently recanalize thrombosed venous sinuses.

Cited by 8 publications

References 7 publications

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment

Shunting in Acute Cerebral Venous Thrombosis: A Systematic Review

Obstructive hydrocephalus resulting from cerebral venous thrombosis

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