Cerebral Venous Thrombosis
Cerebral venous thrombosis is an infrequent type of cerebrovascular accident (CVA) characterized by blood clotting within one or more components of the cerebral venous system (superficial veins, deep veins or venous sinuses), leading to increased cerebral venous pressure, which may cause ischemia and/or intracranial hemorrhage.
Most patients with cerebral venous thrombosis are young, between 20 and 50 years old, and have some associated risk factor. There is a predominance in females, mainly associated with periods of pregnancy, childbirth, puerperium and use of contraceptives. In men, the main cause is head trauma.
Symptoms are diverse and depend on the severity, location and extent of thrombosis.
These include manifestations associated with increased pressure within the skull (headaches, nausea, vomiting, and vision changes), loss of strength and sensitivity in limbs, seizures, behavioral changes, and ringing in the ears. More serious neurological manifestations, such as lowering of the level of consciousness or even coma, are due to intracerebral hemorrhages or severe intracranial hypertension.
In view of the suspicion of cerebral venous thrombosis, the exam of choice to confirm or exclude the diagnosis is angioresonance or angiotomography of the intracranial vessels contrasted with venous phase.
Treatment is with full anticoagulation and generally has a good response. Endovascular treatment (thrombectomy) is reserved for severe cases that do not respond to anticoagulants.
We should always look for the cause of thrombosis to avoid recurrence of the condition.
Why does Venous Thrombosis occur?
Use of oral contraceptives, smoking, obesity, hormone replacement therapy, dehydration, head trauma, anemia, head and neck infections, or the presence of diseases such as cancer, systemic lupus erythematosus, inflammatory bowel disease or hereditary thrombophilia are some of the main risk factors.
What are the possible complications of a Cerebral Venous Thrombosis?
Intracranial bleeding or intracranial hypertension are the most serious complications resulting from cerebral venous thrombosis.
Patients with a history of cerebral venous thrombosis should be closely monitored due to the risk of developing dural arteriovenous fistulas.
