scholarly journals Radiological clinical evaluation of cerebral venous thrombosis

2021 ◽  
Author(s):  
Maely Moreira de Abrantes
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Imaging Techniques ◽  
Correct Diagnosis ◽  
Venous Drainage ◽  
Cerebrovascular Diseases ◽  
Cerebral Veins ◽  
Gold Standard Method ◽  
Invasive Method ◽  
Detailed Assessment

Background: Cerebral venous thrombosis (CVT) is a rare disorder, accounting for 0.5- 1% of cerebrovascular diseases and, in general, affects young people. Occurs due to occlusion of venous sinuses and cerebral veins, which are responsible for the venous drainage of the brain. Symptoms and clinical course are extremely variable, making diagnosis difficult. Objective: The present study aims to conduct a review of the literature on the clinical radiological evaluation in patients with cerebral venous thrombosis. Methods:This is a literature review based on the medical literature and scientific articles indexed in the Scientific Eletronic Library Online (SCIELO) and VHL- Brazil. Results: The evolution, introduction and use of relatively recent imaging techniques have contributed to the early diagnosis and treatment of patients with CVT. Skull computed tomography (CT) is usually the first examination performed in emergency care and can be normal in up to 50% of cases. Skull MRI associated with cranial angioresonance (MRA) are currently the exams of choice for the diagnosis of CVT in the acute, subacute and chronic phases. These tests allow a detailed assessment of the thrombus and tissue changes resulting from CVT. Digital angiography of the skull by catheterization is an invasive method and is considered the gold standard method for the diagnosis of CVT. It is reserved for cases in which NMR is not conclusive or when considering the performance of an endovascular procedure. Conclusions: Imaging studies are of great importance in the diagnosis. Although the venous angiographic study is essential, it is also important to observe the conventional sequences in order to allow a correct diagnosis.

scholarly journals Cerebral Venous Thrombosis: Reviewing Pathophysiology, Diagnosis, and Treatment Strategies

2019 ◽  
Vol 06 (02) ◽  
pp. 140-144 ◽  
Author(s):  
Yasmin A. O'Keefe ◽  
Peter G. Kranz ◽  
Keith E. Dombrowski ◽  
Brad J. Kolls ◽  
Michael L. James
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Treatment Strategies ◽  
Venous Drainage ◽  
Diagnosis And Treatment ◽  
Cerebral Veins ◽  
Heparin Infusion ◽  
Newer Anticoagulants

AbstractThis review discusses cerebral venous thrombosis (CVT), including diagnosis and treatment strategies, a rare class of stroke that, if unrecognized or untreated, can have devastating effects. Thrombosis of one or many cerebral veins leads to propagation of thrombosis and impaired cerebral venous drainage. Diagnosis is made using a combination of history and imaging, particularly computed tomography (CT) venogram, which demonstrates thrombosis. Currently, acute treatment consists of heparin infusion with transition to long-term oral anticoagulation. Further research, especially on prevention, endovascular therapy, and the role of newer anticoagulants (direct oral anticoagulants [DOACs]) is necessary and ongoing.

scholarly journals Cerebral Venous Thrombosis: What's New?

2021 ◽  
Vol 41 (01) ◽  
pp. 025-030
Author(s):  
Diana Aguiar de Sousa
Keyword(s):  
Young Adults ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Cerebral Veins ◽  
Cerebrovascular Disorder ◽  
Recent Advances ◽  
Children And Young Adults

AbstractThrombosis of the cerebral veins and sinuses (CVT) is a distinct cerebrovascular disorder that, unlike arterial stroke, most often affects children and young adults, especially women. In this review, we will summarize recent advances on the knowledge of patients with CVT.

scholarly journals Cerebral venous thrombosis secondary to hyperthyroidism: A case report

2018 ◽  
Vol 15 (1) ◽  
pp. 29-31
Author(s):  
Basant Pant ◽  
Malika Bajracharya ◽  
Avinash Chandra ◽  
Ramita Bati ◽  
Reema Rajbhadari ◽  
...  
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Thrombus Formation ◽  
Thyroid Function Test ◽  
Transverse Sinus ◽  
Severe Headache ◽  
Cerebral Veins ◽  
First Case ◽  
Red Flag

Cerebral Venous Thrombosis (CVT) is a rare form of Stroke characterized by thrombus formation in the cerebral veins. CVT is a result of various reasons among which the hyperthyroidism is not so frequently encountered. This is probably the first case report published from Nepal. The aim of this case report is to give the message that persistent severe headache in patient with hyperthyroidism can be the red flag and needs to be investigated further. We present a case of a 35 years old female who presented with complaints of severe headache and persistent in nature associated with vomiting since 5 days. She was a diagnosed subacute thryroiditis and under medicine from 1 month before presenting to us. Her Magnetic Resonance Venography (MRV) brain showed venous thrombosis within superior saggital sinus, left transverse sinus and sigmoid sinus. Her thyroid function test showed pretreatment T3 of 2.98 ng/ml T4 of 1.02 mg/ ml and TSH of 0.12 μIU/L. She was kept on anticoagulants and other supportive measures. The patient showed improving status with the conservative management.Nepal Journal of Neuroscience 15:29-31, 2018

scholarly journals Cerebral Venous Thrombosis Associated with COVID-19 Infection: An Observational, Multicenter Study

2021 ◽  
pp. 55-60
Author(s):  
Sajid Hameed ◽  
Mohammad Wasay ◽  
Bashir A. Soomro ◽  
Ossama Mansour ◽  
Foad Abd-allah ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Scale Score ◽  
United Arab Emirates ◽  
Cerebral Venous Thrombosis ◽  
Imaging Finding ◽  
Elevated Serum ◽  
Cerebrovascular Diseases ◽  
Modified Rankin Scale ◽  
Female Ratio ◽  
Presenting Symptoms

<b><i>Background and Purpose:</i></b> Coronavirus disease 2019 (CO­VID-19) has an increased propensity for systemic hypercoagulability and thromboembolism. An association with cerebrovascular diseases, especially cerebral venous thrombosis (CVT), has been reported among these patients. The objective of the present study was to identify risk factors for CVT as well as its presentation and outcome in COVID-19 patients. <b><i>Methods:</i></b> This is a multicenter and multinational observational study. Ten centers in 4 countries (Pakistan, Egypt, Singapore, and the United Arab Emirates) participated in this study. The study included patients (aged &#x3e;18 years) with symptomatic CVT and recent COVID-19 infection. <b><i>Results:</i></b> Twenty patients (70% men) were included. Their mean age was 42.4 years, with a male-to-female ratio of 2.3:1. Headache (85%) and seizures (65%) were the common presenting symptoms, with a mean admission Glasgow Coma Scale (GCS) score of 13. CVT was the presenting feature in 13 cases (65%), while 7 patients (35%) developed CVT while being treated for COVID-19 infection. Respiratory symptoms were absent in 45% of the patients. The most common imaging finding was infarction (65%), followed by hemorrhage (20%). The superior sagittal sinus (65%) was the most common site of thrombosis. Acute inflammatory markers were raised, including elevated serum D-dimer (87.5%), erythrocyte sedimentation rate (69%), and C-reactive protein (47%) levels. Homocysteine was elevated in half of the tested cases. The mortality rate was 20% (4 patients). A good functional outcome was seen in the surviving patients, with a mean modified Rankin Scale score at discharge of 1.3. Nine patients (45%) had a modified Rankin Scale score of 0–1 at discharge. <b><i>Conclusion:</i></b> COVID-19-related CVT is more common among males at older ages when compared to previously reported non-COVID-19-related CVT cases. CVT should be suspected in COVID-19 patients presenting with headache or seizures. Mortality is high, but functional neurological outcome is good among survivors.

Role of MRI in Cerebral Venous Thrombosis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eman Ahmad Shawki Geneidi ◽  
Nermeen Nasry Keriakos ◽  
Khaled Mostafa Mohammad Khaled
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Venous Occlusion ◽  
Acute Onset ◽  
Radiology Department ◽  
Cerebral Veins ◽  
Limb Weakness ◽  
Inflammatory Conditions ◽  
Imaging Department ◽  
The Brain

Abstract Background Cerebral venous thrombosis CVT is a type of stroke where the thrombosis occurs in the venous side of the brain circulation, leading to occlusion of one or more cerebral veins and Dural venous sinus. CVT is a potentially life-threatening disease, accounting for approximately 0.5 % of stroke cases. Aim of the Work The aim of this subject is to illustrate the various aspects of CVT on MRI. Patients and Methods This is a retrospective study included 30 patients (19 females &11 males), their ages range from 3 months to 74 years with the median age 22 years. Mean age 22.04 years. The study was performed in radiology department El Demerdash Hospital between March 2018 & September 2019. The study included patients presented to the Medical Imaging Department of Ain Shams university Al-Demerdash hospital with cerebral venous occlusion neurological symptoms or imaging diagnosis. Results In our study,. Most common presenting symptom was headache noted in 22 patients (73.3%) followed by eye manifestations (blurring of vision or clinically having papilledema) was the second most seen in 18 patients (60%). Then comes convulsions in8 patients (26.7 %), Limb weakness in 5 patients (16.7%), finally disturbed consciousness level in 4 patients (13.3%). Most common mode of onset was subacute which was seen in 16 patients (53.3%) acute onset was seen in 6 patients (20%) as predominantly isointense on T1 weighted images and hypo intense on T2 weighted images, chronic onset was seen in 8 patients (26.7%) as hypo intense signal in both T1 and T2 WIs. MRV successfully diagnosed occlusion in most cases by absence of signal intensity with consequent non-visualization of occluded sinuses or veins in almost all patients and except 3 patients; those were having just cortical veins thrombosis detected by T2* sequence electing blooming artifacts with intact sinuses, and dilated distal collaterals seen in 18 patients. Conclusion Dural venous occlusion can occur due to many factors as thrombosis, inflammatory conditions of the brain and tumors. Cerebral venous thrombosis (CVT) has long been a neglected entity because of complexities in diagnosis and non-specific clinical presentation. Conventional MRI and phase contrast MRV in conjugation with recent techniques such SWI & DWI were considered more accurate diagnostic tool, non invasive, non ionizing, with high resolution in evaluating patients with suspected cerebral venous occlusion or thrombosis. It is also considered very useful to demonstrate brain parenchymal affection, the age or stage of the thrombus and its extension

scholarly journals Cerebral Venous Thrombosis in Two Patients with Spontaneous Intracranial Hypotension

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
M. C. Garcia-Carreira ◽  
D. Cánovas Vergé ◽  
J. Branera ◽  
M. Zauner ◽  
J. Estela Herrero ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Superior Sagittal Sinus ◽  
Spontaneous Intracranial Hypotension ◽  
Cerebrospinal Fluid Leak ◽  
Cerebral Veins ◽  
Cortical Vein ◽  
Sagittal Sinus ◽  
Fluid Leak

Although few patients with spontaneous intracranial hypotension develop cerebral venous thrombosis, the association between these two entities seems too common to be simply a coincidental finding. We describe two cases of spontaneous intracranial hypotension associated with cerebral venous thrombosis. In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins. In the other case, only a right frontoparietal cortical vein was involved. Several mechanisms could contribute to the development of cerebral venous thrombosis in spontaneous intracranial hypotension. When spontaneous intracranial hypotension and cerebral venous thrombosis occur together, it raises difficult practical questions about the treatment of these two conditions. In most reported cases, spontaneous intracranial hypotension was treated conservatively and cerebral venous thrombosis was treated with anticoagulation. However, we advocate aggressive treatment of the underlying cerebrospinal fluid leak.

Cerebral Venous Thrombosis

2018 ◽  
pp. 253-264
Author(s):  
Juan Ramos-Canseco ◽  
Maxim Mokin
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Heart Association ◽  
Diagnostic Value ◽  
Surgical Interventions ◽  
Evidence Based Guidelines ◽  
And Control

Establishing the diagnosis of cerebral venous thrombosis (CVT) can often be challenging to physicians. CVT presents with variable symptoms, resulting in delay in establishing the correct diagnosis and treatment. This chapter provides practical recommendations on the currently available diagnostic and treatment options in patients with suspected acute CVT. The diagnostic value of computed tomography, magnetic resonance imaging, and catheter angiography are also discussed. This chapter also includes recommendations for medical treatment with systemic anticoagulation, the role of endovascular therapy, and indications for surgical interventions including hemicraniectomy and control of intracranial pressure. Formal evidence-based guidelines released by the American Heart Association in 2011 are also outlined in this chapter.

scholarly journals Magnetic Resonance Venography Proving its Utility and Standard over Clinical Findings in Diagnosing Cases of Cerebral Venous Thrombosis - A Case Series

2017 ◽  
Vol 4 (1) ◽  
pp. 89
Author(s):  
Abhay G. Kakade ◽  
Rajat Malhotra
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Series ◽  
Disease Process ◽  
Clinical Findings ◽  
Cerebral Veins ◽  
Primary Role ◽  
Wide Range

Introduction: Cerebral venous thrombosis is an uncommon disorder commonly seen in young, earlier this incidence was likely underestimated before the introduction of much accurate &amp; non-invasive imaging modality. Now it has estimated that five to eight cases may be seen per year at a single tertiary-care center. Accurate and prompt diagnosis of cerebral venous thrombosis is crucial; because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term sequelae. Since the possible causes and clinical manifestations of thrombosis are multiple and varied, imaging plays a primary role in the diagnosis. A wide range of cross-sectional imaging methods and venographic techniques can be used to detect abnormalities in the brain parenchyma as well as the cerebral veins and venous sinuses. Materials and Methods: In this study so far 50 patients have been prospectively taken with suspicion of intracranial vascular lesions &amp; were referred to radiology department for MRI Brain with venography irrespective of age and sex. The study has been conducted taking up 50 patients as per the eligibility criteria with written informed consent. Siemens Magnetom Essenza 1.5 Tesla machine was used for the study. Multi-sequential study in coronal, sagittal and axial sections was taken. Results: This study provides a survey of common clinical findings in suspected cases of cerebral venous thrombosis and in several other disorders that may include a venous thrombotic process as a component. The normal venous anatomy has also been reviewed and potential pitfalls related to image interpretation are described. Conclusion: Finally it was concluded from this study, that majority of the patients diagnosed on MR imaging; were seen to be affected with intra-cerebral veins thrombosis. This study proves MR Venography as standard modality in establishing the early diagnosis of CVT in correlation with non-specific clinical findings.

scholarly journals Experimental Cerebral Venous Thrombosis: Evaluation Using Magnetic Resonance Imaging

1996 ◽  
Vol 16 (6) ◽  
pp. 1353-1361 ◽  
Author(s):  
Joachim Röther ◽  
Kim Waggie ◽  
Nick van Bruggen ◽  
Alexander J. de Crespigny ◽  
Michael E. Moseley
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Venous Thrombosis ◽  
Perfusion Imaging ◽  
Cerebral Venous Thrombosis ◽  
Spin Echo ◽  
Vasogenic Edema ◽  
Cerebral Veins ◽  
Resonance Imaging ◽  
Long Term Study

Diffusion-weighted (DWI), dynamic contrast-enhanced (perfusion imaging), and conventional spin-echo magnetic resonance imaging (MRI) were applied to characterize the pathophysiology of cerebral venous thrombosis (CVT) in the rat. We induced CVT by rostral and caudal ligation of the superior sagittal sinus (SSS) and injection of a thrombogenic cephalin suspension. The resulting pathology was monitored in an acute and long-term study group. Evans blue and hematoxylin–eosin staining was performed for comparison with MRI data. A subgroup of animals was treated with i.v. tissue plasminogen activator (t-PA). Successful thrombosis of the SSS was confirmed by macropathology or histopathology in all rats. Parenchymal lesions as shown by MRI, however, were present only in animals with additional involvement of cortical cerebral veins (11 of 18 rats). The early pathology was clearly detected with the DWI. The apparent diffusion coefficient declined to 56 ± 7% of control value at 0.5 h and slowly increased to 84 ± 8% by 48 h. Perfusion imaging showed parasagittal perfusion deficits. Treatment with t-PA partially resolved the hyperintensity on DWI. Evidence of blood–brain-barrier disruption was observed 2 to 3 h after induction of CVT. In conclusion, experimental CVT is characterized by early cytotoxic edema closely followed by vasogenic edema. The t-PA treatment partially reversed the DWI signal changes consistent with regional tissue recovery, as shown by histopathology. These results encourage the use of cytoprotective drugs in addition to anticoagulant or thrombolytic therapy.

scholarly journals Cerebral Venous Thrombosis in the Rhesus Monkey

1981 ◽  
Vol 18 (3) ◽  
pp. 326-334 ◽  
Author(s):  
W. D. Sheffield ◽  
R. A. Squire ◽  
J. D. Strandberg
Keyword(s):  
Ulcerative Colitis ◽  
Central Nervous System ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Rhesus Monkeys ◽  
Venous Occlusion ◽  
Thromboembolic Disease ◽  
Cerebral Veins ◽  
Centrum Semiovale ◽  
Internal Cerebral Veins

Cerebral venous thrombosis was identified in four rhesus monkeys. Two initially showed neurologic signs and three had diarrhea or dysentery. All four had severe intestinal disease, including three cases of ulcerative colitis complicated by extracerebral thromboembolic disease. Central nervous system lesions, confined to the centrum semiovale, were multiple thrombi of internal cerebral veins, perivenular demyelination, and gemistocytic astrocytosis. The lesions resembled those found in people with cerebral venous thrombosis, and support the hypothesis that perivenular demyelination may occur as a sequela to venous occlusion. The lesions were identical to those found in “leukoencephalosis and perivascular myelosis,” an entity of unknown cause previously described in monkeys.

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