Cerebral Venous Thrombosis Not Including Cavernous Sinus

Cerebral venous thrombosis (CVT) is a rare entity that can be difficult to diagnose and for which imaging studies can be normal. Routine measurement of the opening pressure of spinal fluid is one safeguard for not missing the diagnosis. CVT should be considered in patients with severe headache without other explanation.

Causes

• Mostly the causes of septic cerebral venous thrombosis may occur due to an acute infection and patients who have chronic sinusitis or diabetes mellitus, then it may be at a slightly higher risk.
• Most frequent cause of cerebral venous thrombosis (CVT) is transtentorial herniation, it may occur due to either a focal mass effect or to multiple lesions and edema.

Symptoms

• Headache ++++, not location specific
• Vomiting +++
• Thunderclap headache +
• Focal neurologic deficit ++
• Seizures ++ focal or generalized

Signs

• Papilledema +++
• Mental status changes ++
• Cranial nerve palsies ++
• Dysarthria or dysphasia ++
• Hemiplegia

Treatment

• For the treatment of cerebral venous thrombosis (CVT), corticosteroids is the best. Because it helps to reduce inflammation and edema. It should be considered as an adjunctive therapy. When the CST leads to pituitary insufficiency, then corticosteroids definitely are indicated to prevent adrenal crisis.
• You can also used the other treatments for CVST such as including anti-thrombotic therapy with UFH, LMWH, oral anticoagulants, intravenous thrombolysis with urokinase, rtPA.
• Other treatment such as includes hydration and anticonvulsant is contraindicated in pregnancy because they cross the human placenta and it may cause uterine atony.