66 - CEREBRAL VENOUS SINUS THROMBOSIS

Summary

Cerebral venous sinus thrombosis (CVST), although a relatively rare cause of stroke, is important to diagnose and treat early because of the significant morbidity and mortality associated with it. CVST tends to affect younger patients, who have fewer traditional risk factors, than do arterial infarcts. CVST can also follow traumatic injury to the venous sinuses or jugular veins after neurosurgical or other procedures. Bilateral basal ganglionic and thalamic infarcts or hemorrhages are pathognomic of deep venous involvement. Magnetic resonance imaging (MRI) and computed tomography (CT) scanning are essential in confirming the diagnosis of CVST. The major pathology in CVST is thrombosis of cerebral veins or dural sinuses leading to impaired drainage, venous hypertension with subsequent edema formation, venous infarction, and hemorrhage. Anticoagulation plays a central role in management of intracranial venous occlusive disease. Anticoagulants are likely to prevent further thrombus growth and propagation, helping to arrest the thrombotic process.