scholarly journals Cerebral Venous Sinus Thrombosis: Two Case presentations with different clinical manifestations and multifactorial etiology

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Anusha Skandini Ganeshan ◽  
Angel Alberto Caderon Chango
Keyword(s):  
Young Adults ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Medical Practitioner ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
First Case

Cerebral Venous Sinus Thrombosis (CVST) is a rare form of venous thrombosis which commonly affects young adults. CVST has variable clinical presentation such as headache, seizure, hemiparesis and even coma, thus mimicking stroke and other neurological disorders. Due to such non-specific wide spectrum of clinical presentations and variable etiology in young adults, CVST can be misdiagnosed easily, especially in initial stages of presentation which consequently affects the outcome and prognosis of the patient. Thus when a previously healthy young adults acutely presented with such variable but primarily neurological clinical presentation, it is vital for medical practitioner to have fine knowledge and skills to suspect CVST as a differential diagnosis. We present two cases: first case is a 21 year old female with puerperal CVST who had caesarean section under spinal anaesthesia three weeks before, who presented with headache and recurrent seizures, followed by hemiparesis; the second case is a 25 year old female with CVST, on oral contraceptives, who presented with right monoparesis, aphasia and facial asymmetry. In both cases though CVST was not the initial diagnosis, it was subsequently diagnosed early and confirmed by MRI brain and MRI angiogram and anticoagulation was commenced effectively, despite associated haemorrhagic infarct in the first case. Both patient made remarkable recovery without any significant residual neurological deficit.

scholarly journals Cerebral venous sinus thrombosis associated with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection

2021 ◽  
pp. 104-104
Author(s):  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
Vladimir Manojlovic ◽  
Zeljko Zivanovic ◽  
Sanja Vickovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Neurological Symptoms ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

Introduction/Objective. Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. Objective: to present a series of CVST cases associated with SARS-CoV-2 infection. Methods. This retrospective study evaluated clinical, laboratory and radiological presentation, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection induced CVST. Results. The study comprised 6 patients diagnosed with COVID-19 induced CVST during the 18 months period. Majority (66.7%) had no significant risk factors for developing CVST. Median time from initial COVID-19 diagnosis to onset of neurologic deficit was 7 days (interquartile range 0.5-7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomarkers. The transverse (n = 4 or 66.7%), superior sagittal sinuses (n = 3 or 50%) and sigmoid sinus (n = 2 or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ? 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion. The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications.

scholarly journals Cerebral Venous Sinus Thrombosis Associated with COVID-19: A Case Series and Literature Review

2020 ◽  
Author(s):  
Vahid Reza Ostovan ◽  
Razieh Foroughi ◽  
Mahtab Rostami ◽  
Mostafa Almasi-Dooghaee ◽  
Manouchehr Esmaili ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Cerebral Venous Sinus Thrombosis ◽  
Hemorrhagic Transformation ◽  
Venous Sinus ◽  
Teaching Hospitals ◽  
Venous Sinus Thrombosis ◽  
North West ◽  
Confirmatory Tests

Abstract Background: Since the COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals. This study provides a series of patients with CVST and SARS-CoV-2 infection.Methods: Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran from June to July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, main COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated.Results: Six patients (aged 31 to 62 years old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five out of six patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four out of six patients passed away.Conclusions: The role of SARS-CoV-2 as a “cause” versus an “additive contributor” remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection.

Cerebral Venous Sinus Thrombosis due to Thrombosis with Thrombocytopenia Syndrome Following Ad26.COV2.S: A First Real-World Case Report of a Male Subject

2021 ◽  
pp. 194187442110550
Author(s):  
Samia Asif ◽  
Meghana Kesireddy ◽  
Scott A. Koepsell ◽  
Marco A. Gonzalez-Castellon ◽  
Krishna Gundabolu ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Young Male ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Platelet Factor ◽  
Venous Sinus Thrombosis ◽  
Vein Thrombosis ◽  
First Case ◽  
Control And Prevention ◽  
Underlying Pathophysiology

Thrombosis with Thrombocytopenia Syndrome (TTS) or Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT) had been reported in patients receiving the Ad26.COV2.S vaccination (Johnson & Johnson [J&J]/Janssen) vaccine. They frequently presented with cerebral venous sinus thrombosis (CVST), but venous or arterial thrombosis at other locations can be present. The majority of those affected are younger adult females. Therefore, after a brief pause from April 13–23, 2021, the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) recommended caution in using this vaccine in females under 50 years. Based on the reported 28 cases of TTS after this vaccination (data till April 21, 2021) by CDC, 22 were females (78%), and 6 were male. None of those males had CVST but had thrombosis at other locations. We report the first case of a young male with TTS and CVST following Ad26.COV2.S vaccine presented with severe headache and diagnosed with acute right transverse and sigmoid cerebral venous sinus thrombosis, multiple right-sided pulmonary emboli, and right hepatic vein thrombosis. He was treated with parenteral anticoagulation with argatroban and intravenous immune globulin with the improvement of his symptoms. A heparin-induced thrombocytopenia with thrombosis (HITT) like syndrome caused by the genesis of a platelet-activating autoantibody against platelet factor 4 (PF4) triggered by adenoviral vector-based COVID-19 vaccinations is understood to be the underlying pathophysiology. TTS with CVST should be considered when patients present with headaches, stroke-like neurological symptoms, thrombocytopenia, and symptom onset 6–15 days after Ad26.COV2.S vaccination.

scholarly journals A Case Report of Cerebral Venous Sinus Thrombosis in Palestine: The Importance of Rapid Diagnosis and Treatment of CVST

2019 ◽  
Vol 4 (6) ◽  
Keyword(s):  
Case Report ◽  
Sinus Thrombosis ◽  
Brain Mri ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Successful Outcome ◽  
Venous Sinus Thrombosis ◽  
Brain Ct ◽  
First Case

Cerebral venous sinus thrombosis (CVST) is an often under-diagnosed, life-threatening condition. We report the first case of CVST in Palestine of a 39-year-old female who presented with a history of loss of consciousness preceded by severe vertigo and headache. Brain CT scan without contrast was done, in which no abnormality was detected. Further Brain MRI and MRV studies with contrast showed thrombosis of left transverse sinus with extension to left sigmoid sinus and left jugular vein. The patient was anticoagulated and admitted to the ICU for regular monitoring and frequent brain CT scans to rule out hemorrhagic transformation. The patient made a full recovery. Lab and molecular studies were carried out as an outpatient to investigate the etiology of this presentation. The aim of this case report is to demonstrate the importance of early detection and treatment of CVST for a successful outcome.

Clinical Profile And Risk Factors of Cerebral Venous Sinus Thrombosis (CVST) in Sudan

2021 ◽  
Author(s):  
Etedal Ahmed A Ibrahim ◽  
Rofiedah Eisa Hassan Mohamed ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Mohammed Eltahier Abdalla Omer
Keyword(s):  
Risk Factors ◽  
Sinus Thrombosis ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Venous Sinus Thrombosis

Abstract Background Cerebral venous sinus thrombosis (CVST) is relatively uncommon cause of stroke mainly affects young ladies, with a wide spectrum of symptoms severity and prognosis. In this study we aim to study the clinical profile and Risk Factors of CVST among Sudanese patients in Khartoum state hospitals. Methods This is an observational cross-sectional multi-center hospital based study which covered 37 participants, in three major hospitals in khartoum, with radiologically confirmed Cerebral Venous Sinus Thrombosis (CVST) Results 37 patients were included in this study, The mean age of patients was 38.5 ± 13.4 years, with minimum age of 23 years and maximum of 75 years, the largest group (n = 18, 48.6%) were in the range between “26–35” years, regarding gender distribution (n = 8; 21.6%) were males and the majority of patients were female (n = 29; 78.4%), the commonest presenting feature was headache (n = 35; 94.6%), followed by blurring of vision (n = 25; 67.6%), while seizures is a presenting symptom in nearly half of the patients (n = 17; 45.9%), on examination papilloedema was present in 83.8%. In this study 13.8% were pregnant, 31.0% were postpartum, OCPS user account for 27.%, and No risk factor present in 32.4%. regarding the involved sinus Sagittal Venous Sinus and the transverse sinus were the most affected sinuses. Regarding treatment options: “low molecular weight heparin followed with warfarin” was found in 81.1%, followed with heparin only 10.8%, while the new agents NOACs comprised only 8.1%. Conclusion The study concluded that Cerebral Venous Sinus Thrombosis is mainly a disease of child-bearing women, although significant proportions of men were affected. Cerebral Venous Sinus Thrombosis presents in a wide variety of signs and symptoms.

scholarly journals Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review.

2020 ◽  
Author(s):  
Massimo Luca Castellazzi ◽  
Giada Maria di Pietro ◽  
Michele Gaffuri ◽  
Sara Torretta ◽  
Giorgio Conte ◽  
...  
Keyword(s):  
Literature Review ◽  
Otitis Media ◽  
Surgical Therapy ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

Abstract Background Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011. Case presentation The child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient’s full recovery.Conclusion Cerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.

scholarly journals Cerebral Venous Sinus Thrombosis- A Study of 4 Cases

2017 ◽  
Vol 33 (1) ◽  
pp. 30-33
Author(s):  
Abdul Kader Sheikh ◽  
Rama Biswas ◽  
Anindita Roy ◽  
Sadiqa Tuqan ◽  
Mallika Sarker ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Focal Neurological Deficit ◽  
Venous Sinus Thrombosis ◽  
Aged Woman ◽  
Supportive Management ◽  
Variable Presentation

Cerebral venous sinus thrombosis is an uncommon but important cause of stroke, especially in young-aged woman. Clinical presentation is variable, usually in the form of focal neurological deficit, seizure, headache and other features of raised intracranial pressure, leading to misdiagnosis or delay in treatment. Here we report 4 cases of venous sinus thrombosis with variable presentation. Diagnosis is confirmed by neuroimaging including magnetic resonance imaging with magnetic resonance venography of brain. Treatment consists of anticoagulation along with supportive management. Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 30-33

scholarly journals Successful treatment of cerebral venous sinus thrombosis by balloon venoplasty: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110632
Author(s):  
Wei Chen ◽  
Wen-Jing Gu ◽  
Ming-Chao Shi ◽  
De-Rui Kong ◽  
Ke-Xin Zhao ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Sinus Thrombosis ◽  
Clinical Manifestations ◽  
Cerebral Venous Sinus Thrombosis ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Aged People ◽  
The Right

Cerebral venous sinus thrombosis is a special cerebrovascular disease affecting young adult and middle-aged people. The clinical manifestations of cerebral venous sinus thrombosis are diverse and nonspecific; thus, imaging plays an important role in early diagnosis. Anticoagulation with heparin is the preferred treatment for cerebral venous sinus thrombosis. Endovascular treatment is also being increasingly used to achieve recanalization of the cerebral venous sinus. We herein describe a woman in her early 50s who was diagnosed with cerebral venous sinus thrombosis for which anticoagulation with heparin was ineffective. To improve her symptoms and prognosis, we selected balloon venoplasty to treat the right sigmoid sinus thrombosis. Her condition subsequently improved, and no recurrence was observed after several follow-ups.

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