scholarly journals Superior Ophthalmic Vein Thrombosis with Cerebral Venous Sinus Thrombosis: A Rare Entity in a Child

2019 ◽  
Vol 9 (2) ◽  
pp. 127-132
Author(s):  
Kanij Fatema ◽  
Muhammad Mizanur Rahman ◽  
Laila Areju Man Banu
Keyword(s):  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
High Dose ◽  
Partial Recovery ◽  
Superior Ophthalmic Vein ◽  
Venous Sinus Thrombosis ◽  
Vein Thrombosis ◽  
Methyl Prednisolone

Cerebral venous sinus thrombosis (CVST) is a rare stroke-like syndrome. Sometimes it may be rarely associated with ophthalmic vein occlusion. We present a 10-year-old girl who had severe headache, diplopia, severe congestion of eye, proptosis and orbital pain. She had no signs of meninigeal irritation, no focal deficit except left sided lateral rectus palsy and altered visual acuity. Investigations regarding vasculitis and thrombophillia were normal except thrombocytosis. MRI of brain showed ‘dense triangle sign’ and thickened superior ophthalmic vein. Magnetic resonance venography (MRV) showed occlusion of superior sagital sinus and transverse sinus. She was treated with paracetamol, acetazolamide, rivaroxaban and antibiotics followed by high dose pulse methyl prednisolone. She made a partial recovery within one week and at 3 months follow-up she was completely normal. J Enam Med Col 2019; 9(2): 127-132

scholarly journals Diagnosis and Management of Lemierre’s Syndrome Presented with Multifocal Pneumonia and Cerebral Venous Sinus Thrombosis

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yasar Sattar ◽  
Ammu Thampi Susheela ◽  
Bibek Karki ◽  
Adnan Liaqat ◽  
Waqas Ullah ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Fusobacterium Nucleatum ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Jugular Vein Thrombosis ◽  
Lemierre Syndrome ◽  
Venous Sinus Thrombosis ◽  
Vein Thrombosis ◽  
Cerebral Sinus Venous Thrombosis ◽  
Magnetic Resonance Imaging Mri

A 27-year-old female patient initially presented with fever, myalgia, sore throat that progressed to multifocal pneumonia, and cerebral sinus venous thrombosis. A combination of upper respiratory symptoms with tooth infection, positive blood culture for Fusobacterium nucleatum, computed tomography (CT) chest finding of multifocal pneumonia, and magnetic resonance imaging (MRI) finding of internal jugular vein thrombosis (IJVT) and cerebral venous sinus thrombosis (CVST) suggested Lemierre syndrome. The patient was managed with fluids, antibiotics, and anticoagulants. The patient survived and discharged from the hospital. The patient’s symptoms improved at 2 months of follow-up.

Fatal cerebral venous sinus thrombosis as major complication of metastatic cervical mass: computed tomography and magnetic resonance findings

2000 ◽  
Vol 114 (10) ◽  
pp. 798-801 ◽  
Author(s):  
Maria F. López-Peláez ◽  
José M. Millán ◽  
Joaquin de Vergas
Keyword(s):  
Sinus Thrombosis ◽  
Major Complication ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Jugular Vein Thrombosis ◽  
Cervical Mass ◽  
Venous Sinus Thrombosis ◽  
Vein Thrombosis ◽  
Sagittal Sinus ◽  
Common Causes

Cerebral venous sinus thrombosis is an uncommon but potentially lethal condition, with mortality between 5.5–30 per cent. It was previously associated with infections of the orbit, mastoid or face, but, after the advent of antibiotics, the most common causes include neoplasms, dehydration, oral contraceptives, coagulopathies, collagen diseases, and pregnancy and the puerperium. We report a case of fatal cerebral venous sinus thrombosis in a 68-year-old patient with a metastatic cervical mass, who developed internal jugular vein thrombosis that progressed cranially to transverse and sagittal sinus thrombosis.

Headache in cerebral venous sinus thrombosis revisited: Exploring the role of vascular congestion and cortical vein thrombosis

Cephalalgia ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 503-510 ◽  
Author(s):  
Ravinder-Jeet Singh ◽  
Jitender Saini ◽  
Shriram Varadharajan ◽  
Girish Baburao Kulkarni ◽  
Mustare Veerendrakumar
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Dural Sinus Thrombosis ◽  
Venous Sinus Thrombosis ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
Vascular Congestion

Background and purpose Headache constitutes the most common symptom of cerebral venous sinus thrombosis (CVST), but its pathophysiology is unclear. We sought to investigate the potential mechanism for headache genesis in patients with CVST based on its imaging correlates. Methods A subgroup of CVST patients having headache as the predominant symptom without significant parenchymal lesion were retrospectively analysed for imaging features of vascular congestion (VC), in addition to cortical venous (CVT) and dural sinus thrombosis (DST) on magnetic resonance imaging. Headache and imaging patterns were classified into lateralized and nonlateralized phenotypes and their correlation was sought. Results Among 41 patients included, 28 had lateralized headache (LH group; 15 males; mean age 32.25 ± 9.19 years) while 13 had nonlateralized headache (non-LH group; six males; mean age 27.15 ± 8.65 years). Headache characteristics in both the groups were quite similar. Imaging showed VC in 39 of 41 and CVT among 35 of 41 patients, which were lateralized in 23 of 39 and 18 of 35 patients, respectively. Nearly all lateralized imaging patterns (21 of 23 for VC and 17 of 18 for CVT) occurred in the LH group and ipsilateral to (concordant) headache, while the non-LH group showed lateralized VC and CVT in only two and one patient respectively. Sinus thrombosis was lateralized in both groups irrespective of headache laterality. Whole cohort headache-imaging laterality (including patients with nonlateralized headache and nonlateralized imaging) concordance was 31 of 39, 24 of 35 and 18 of 41 for vascular congestion, cortical vein thrombosis and dural sinus thrombosis respectively. Conclusion Co-localization of VC and CVT with overlying headache might provide a possible explanation of headache and its laterality in patients with CVST.

Abstract 1122‐000170: Stent Retrievers Utilization in Endovascular Treatment of Cerebral Venous Sinus Thrombosis

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Abdallah O Amireh ◽  
Hassan Ali ◽  
Muhammad Nagy ◽  
Siddhart Mehta ◽  
Haralabos Zacharatos ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Stent Retriever ◽  
Venous Sinus ◽  
Heparin Infusion ◽  
Venous Sinus Thrombosis ◽  
History Of ◽  
Stent Retrievers

Introduction : Patients with Cerebral Venous Sinus Thrombosis (CVT) are candidates for Endovascular Mechanical Thrombectomy (EMT) in cases of coma on presentation or clinical deterioration despite anticoagulation. We present two cases of CVT successfully treated with mechanical thrombectomy using Medtronic’s Solitaire Stent retriever. Methods : A retrospective review at a single center university hospital was performed for all cerebral venous sinus thrombosis case log from December 2018 to November 2020. Cases resistant to conventional medical therapy that underwent intrasinus stent retriever endovascular thrombectomy were noted. Results : Case 1: 26 year‐old male with a history of hypertension presented with 2 weeks of headaches, left sided numbness and blurriness of vision. Imaging revealed superior sagittal (SSS) and bilateral transverse sinus thrombosis. Patient was treated with heparin infusion and discharged home on oral apixaban. The following day he presented with new onset expressive aphasia. Imaging was unchanged. Due to worsening symptoms despite anticoagulation, Patient underwent mechanical thrombectomy using a stent retriever. Solitaire 6 × 40 mm stent was advanced and deployed through the microcatheter and retracted in the upper segment of posterior one third of SSS followed by alteplase infusion at 1 mg/hr (25 ml/hr) via Berenstein catheter for the next 36 hours. Intravenous heparin infusion was also started with aPTT goal 60–80. Cerebral angiogram was repeated two days later revealing successful recanalization of previously thrombosed SSS and bilateral transverse sinuses with significantly improved cerebral venous drainage. Patient was transitioned again to oral apixaban. Repeat CTA in 3 months showed significantly improved patency and recanalization. Case 2: A 42 year‐old male with history of ulcerative colitis presented with sudden onset right‐sided hemiparesis and hemisensory loss along with one month of headaches. Presenting NIHSS 14. Imaging revealed SSS thrombosis with thrombosis of the left transverse sinus complicated by left frontal intraparenchymal hemorrhage and subarachnoid hemorrhage. Patient underwent mechanical thrombectomy of SSS using Solitaire 6 × 40mm stent retriever with distal aspiration resulting in improved flow. Clinical course was complicated by seizures and acute respiratory distress syndrome requiring intubation followed by tracheostomy and G‐tube placement which were eventually removed during recovery. Patient was treated with high intensity heparin during his hospitalization and eventually transitioned to apixaban. Work up revealed protein S deficiency. Serial CT angiograms at 6 and 11 months revealed resolution of CVT. NIHSS improved to 1 with mRS of 2. Conclusions : These cases imply that intra‐cerebrovenous sinus mechanical thrombectomy with stent retrievers may be considered in patients with continuing worsening despite optimal medical management.

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.

Management and outcome of spontaneous cerebral venous sinus thrombosis in a 5-year consecutive single-institution cohort

2016 ◽  
Vol 9 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Darrin J Lee ◽  
Arjang Ahmadpour ◽  
Tamar Binyamin ◽  
Brian C Dahlin ◽  
Kiarash Shahlaie ◽  
...  
Keyword(s):  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Venous Sinus Thrombosis ◽  
Sagittal Sinus ◽  
The Impact

BackgroundCerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with a variable presentation, ranging from headaches, to coma and death. Although the American Stroke Association has developed guidelines for the treatment of CVST, data are sparse on the outcome after treatment with anticoagulation, thrombolysis, and thrombectomy.MethodsIn this retrospective review, we describe the 5-year UC Davis experience with spontaneous CVST.ResultsForty-one patients (mean age 37.5±23.1, range 0–96 years; 29 female) were identified with CVST. The majority of cases involved the transverse sinus (75.6%), sigmoid sinus (58.5%), and superior sagittal sinus (29.3%). The most common form of treatment was anticoagulation or antiplatelet therapy (n=35), while six patients were managed by observation alone. The overall 1-year modified Rankin score (mRS) was 1.4±1.5. Male patients and patients with a poor admission mRS had a worse outcome. Outcome was unaffected by hypercoagulable state, number of dural sinuses involved, the presence of intracranial hemorrhage, or seizures. Two patients who underwent anticoagulation therapy also required endovascular thrombectomy; both patients had a 1-year mRS of ≤2. Two patients underwent direct open surgical canalization of the superior sagittal sinus with varying outcomes (mRS 2 vs mRS 6).ConclusionsIn our series, the majority (92.9%) of patients with spontaneous dural sinus thrombosis had a favorable clinical outcome as defined by a mRS ≤2. Further prospective studies are needed to study the impact of anticoagulation on the clinical course of the disease.

scholarly journals Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

2013 ◽  
Vol 04 (03) ◽  
pp. 313-316 ◽  
Author(s):  
Fardin Faraji ◽  
Farshid Didgar ◽  
Afsoon Talaie-Zanjani ◽  
Abolfazl Mohammadbeigi
Keyword(s):  
Magnetic Resonance ◽  
Sinus Thrombosis ◽  
Good Condition ◽  
Complex Partial Seizure ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Laboratory Assessment ◽  
Venous Sinus Thrombosis ◽  
High Doses

ABSTRACTCerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

scholarly journals Clinical Characteristics and Management of Cerebral Venous Sinus Thrombosis in Patients With Antiphospholipid Syndrome: A Single-Center Retrospective Study

2021 ◽  
Vol 27 ◽  
pp. 107602962199910
Author(s):  
Huixin Shen ◽  
Xiaoqin Huang ◽  
Chunqiu Fan
Keyword(s):  
Antiphospholipid Syndrome ◽  
Endovascular Therapy ◽  
Clinical Characteristics ◽  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Good Prognosis ◽  
Venous Sinus ◽  
Initial Manifestation ◽  
Venous Sinus Thrombosis

Antiphospholipid syndrome (APS) with cerebral venous sinus thrombosis (CVST) is a relatively rare phenomenon, and this observational study aimed to investigate the clinical characteristics of APS patients complicated with CVST. We retrospectively investigated the clinical characteristics of CVST events in APS and compared differential characteristics and associated factors between APS patients with and without CVST. Twenty-one CVST patients with APS were enrolled including 14 females (9.4%) and 7 males (5.8%). The median age and disease duration at onset of CVST was 33 years (IQR 28-48) old and 1.3 months (IQR 0.7-4), respectively. Among APS patients with CVST, 12 (57.1%) cases presented with neurologic symptoms of CVST as the initial manifestation. Onset of CVST was mainly chronic (52.4%). Headache (90.5%) was the most common neurological symptom. The common locations of CVST were transverse sinus (76.2%) and superior sagittal sinus (57.1%), with more frequently (76.2%) dual or multiple sinuses involved. All patients with CVST were treated with anticoagulant, and 5 (23.8%) patients received endovascular therapy. Sixteen (84.2%) patients had good outcomes and 3 (15.8%) patients died at last follow-up. There were no significant differences ( P > 0.05) between two groups in the analysis of related APS indicators. There were no significant differences ( P > 0.05) between two groups in the analysis of related APS indicators. Although APS complicated with CVST is rare and predominately chronic developed. The evaluation of CVST should be performed for APS patients with intracranial hypertension syndrome. The routine screening of antiphospholipid antibodies (aPLs) is highly recommended in unexplained CVST patients. Most CVST patients with APS will have a good prognosis after treatment, and endovascular therapy is an alternative treatment.

Sign in / Sign up

Export Citation Format

Share Document