The Diagnosis and Treatment of Cerebral Venous Thrombosis

Abstract

Serebral venöz sinüs trombozu, dural sinüslerin ve/veya venlerin trombozunu içerir. Tüm inmelerin %0,5-1'ini oluşturur ve genellikle gençlerde görülür. Gebelik, puerperyum ve oral kontraseptif kullanımı nedeni ile genç kadınlarda biraz daha fazla görülmektedir. Hastalar genellikle baş ağrısı veya fokal nörolojik defisit nedeni ile başvurur. En sık superior sagittal sinüs etkilenir. Sinüslerin atrezisi/hipoplazisi, asimetrik sinüs drenajı gibi venöz anatomideki varyasyonlar sinüs trombozunu taklit edebilir. Genel olarak manyetik rezonans görüntüleme kullanımı bilgisayarlı tomografi kullanımına göre trombozun tüm dönemlerinde tanı için daha duyarlıdır. Tedavide ilk tercih edilecek ilaç grubu antikoagülanlardır. Anahtar Kelimeler: Antikoagülasyon, tromboz, venöz sinüsCerebral venous sinus thrombosis involves thrombosis of the dural sinuses and/or cerebral veins. It constitutes 0.5-1% of all strokes and usually affects young individuals. It is slightly more common in young women due to pregnancy, puerperium, and oral contraceptive use. Patients usually present with headache or focal neurologic deficits. The superior sagittal sinus is most frequently affected sinus. Variations in venous anatomy, such as atresia/hypoplasia of the sinuses or asymmetric drainage of the sinus, may mimic sinus thrombosis. In general, magnetic resonance imaging is more sensitive than computed tomography in the detection of cerebral venous sinus thrombosis at each stage. Anticoagulants are the first preferred group of drugs in the treatment.

Bacterial Meningitis Complicated by Venous Sinus Thrombosis: a Case of a Pregnant Woman

“…Venous sinus thrombosis is a common and severe complication in adults with bacterial meningitis (6). Underlying hormonal factors such as pregnancy and infections increase the risk of thrombosis (8). Venous sinus thrombosis secondary to infection may not be indistinguishable from stroke and therefore requires clinical suspicion to make an accurate diagnosis.…”

Investigation of sinus vein thrombosis cases detected in the emergency department

“…MRV is mostly used to confirm sinus vein thrombosis. In addition, observing isointense or hyperintense filling in the sinus in T1, T2, and FLAIR sequences is an important finding to distinguish SVT from anatomical variations (1). The postpartum period includes the 6-month period after the termination of pregnancy (9).…”

“…Deep veins, on the other hand, consist of transverse sinus, vein of Galen, straight and occipital sinuses and drain into dural sinuses. Finally, this structure drains into the vena jugularis interna (1). Thrombus in this venous circulation in the brain causes sinus vein thrombosis (SVT) (2).…”

Associations Between Doppler Internal Jugular Vein Blood Flow and Transverse Sinus Stasis Detected by Magnetic Resonance Imaging

“…2 The diagnosis of cerebral venous thrombosis may be made further because of the increasing development of radiologic imaging methods. 3 Many radiologic modalities are used in imaging dural venous sinuses. Computed tomographic venography, magnetic resonance imaging (MRI), time-of-flight magnetic resonance venography), contrast-enhanced magnetic resonance venography, and digital subtraction angiography are the most widely used radiologic imaging methods.…”

“…According to another study, the incidence of cerebral venous thrombosis is estimated at 0.2 to 0.5 per 100 000 per year 2 . The diagnosis of cerebral venous thrombosis may be made further because of the increasing development of radiologic imaging methods 3 . Many radiologic modalities are used in imaging dural venous sinuses.…”