Cerebral Venous Thrombosis: CVT
Keywords:
cerebral venous thrombosis, CVT, anticoagulant, headacheAbstract
Objectives: Cerebral venous sinus thrombosis (CVT) is a rare type of stroke but associated with a potential of high morbidity and mortality. CVT mostly affects young adults especially women. The currently available data data about the epidemiology, diagnosis, management and prognosis of CVT were reviewed. Findings: CVT is found to be 0.5% of all case of all stroke, but can be challenging for diagnosis because it usually presents with headache rather than focal neurological deficit.Magnetic resonance imaging and venography (MRI& and MRV) of brain is the preferred imaging modality to confirm diagnosis of CVT.Main treatment is anticoagulant. Other methods are reserved for medical failure or CVT with complication. Additionally, attempt to search for risk factors and correct the underlying causes is also essential step for treatment and prevention of recurrence. Conclusion: CVT is a rare, but treatable condition that physicians should keep in mind in any patients who present with headache and quite sudden focal neurological deficits.
References
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Ferro J, Canhao P, Stam J, et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus
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deVeber G, Andrew M, Adams C, et al. Cerebral sinovenous thrombosis in children. N Engl J Med 2001;345:417-423.
Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005;352: 1791-1798.
Crassard I, Bousser MG. Headache in patients with cerebral venous thrombosis [in French]. Rev Neurol (Paris) 2005;161:706-708.
Girot M, Ferro JM, Canha˜o P, et al. Predictors of outcome in patients with cerebral venous thrombosis and intracerebral hemorrhage.Stroke 2007;38:337-342.
Saposnik G, Barinagarrementeria F, Brown R, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals
from the American Heart Association/American Stroke Association.Stroke 2011;42:1158-1192.
Biousse V, Ameri A, Bousser MG. Isolated intracranial hypertension as the only sign of cerebral venous thrombosis. Neurology 1999;53:1537-1542.
Roach ES, Golomb MR, Adams R, et al. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart
Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 2008;39:2644-2691.
Dentali F, Squizzato A, Marchesi C, et al. D-dimer testing in the diagnosis of cerebral vein thrombosis: a systematic review and a meta-analysis of the
literature. J Thromb Haemost 2012;10:582-589.
Hiltunen S, Putaala J, Haapaniemi E, et al. D-dimer and clinicoradiologic features in cerebral venous thrombosis. J Neurol Sci 2013;327:12-14.
Leach MJ, Gall SL, Dewey HM, et al. Factors associated with quality of life in 7-year survivors of stroke. J Neurol Neurosurg Psychiatry 2011;82:1365-1371.
Einha¨ upl K, Bousser MG, de Bruijn SF, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis. Eur J Neurol 2006;13:553-559.
Leach JL, Fortuna RB, Jones BV, Gaskill-Shipley MF. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics 2006;26:S19-S41.
Selim M, Fink J, Linfante I, et al. Diagnosis of cerebral venous thrombosis with echo-planar T2*-weighted magnetic resonance imaging. Arch Neurol 2002;59:1021-1026.
Bousser, MG, Russell, RR. Cerebral venous thrombosis. In: Warlow, CP, Van Gijn, J editors. Major Problems in Neurology. London, WB Saunders; 1997:27-104.
Sztajzel R, Coeytaux A, Dehdashti AR, et al. Subarachnoid hemorrhage: a rare presentation of cerebral venous thrombosis. Headache 2001; 41:889-891.
Oppenheim C, Domigo V, Gauvrit JY, et al. Subarachnoid hemorrhage as the initial presentation of dural sinus thrombosis. Am J Neuroradiol 2005; 26:614-617.
Spitzer C, Mull M, Rohde V, Kosinski CM. Nontraumatic cortical subarachnoid haemorrhage: diagnostic work-up and aetiological background. Neuroradiology 2005; 47:525-531.
Virapongse C, Cazenave C, Quisling R, et al. The empty delta sign: frequency and significance in 76 cases of dural sinus thrombosis. Radiology 1987;
162:779-785.
Lee EJ. The empty delta sign. Radiology 2002; 224:788-9.
Boukobza M, Crassard I, Bousser MG. When the “dense triangle” in dural sinus thrombosis is round. Neurology 2007; 69:808.
Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis. Continuum (Minneap Minn) 2014;20:335–351.
Wasay M, Azeemuddin M. Neuroimaging of cerebral venous thrombosis. J Neuroimaging 2005;15:118-128.
Ganeshan D, Narlawar R, McCann C, et al. Cerebral venous thrombosis-a pictorial review. Eur J Radiol 2010;74:110-116.
Coutinho JM, Ferro JM, Canha˜o P, et al. Cerebral venous and sinus thrombosis in women. Stroke 2009;40:2356-2361.
Lijfering WM, Brouwer JL, Veeger NJ, et al. Selective testing for thrombophilia in patients with first venous thrombosis: results from a retrospective family cohort
study on absolute thrombotic risk for currently known thrombophilic defects in 2479 relatives. Blood 2009;113:5314-5322.
Martinelli I, Bucciarelli P, Passamonti SM, et al. Long-term evaluation of the risk of recurrence after cerebral sinus-venous thrombosis. Circulation 2010;121:2740-2746.
Einha¨ upl KM, Villringer A, Meister W,et al. Heparin treatment in sinus venous thrombosis. Lancet 1991;338:597-600.
de Bruijn S, Stam J. Randomized,placebo-controlled trial of anticoagulant treatment with low-molecularweight heparin for cerebral sinus thrombosis. Stroke
1999;30:484-488.
Coutinho J, de Bruijn SF, Deveber G, Stam J. Anticoagulation for cerebral venous sinus thrombosis. Cochrane Database Syst Rev 2011;(8):CD002005.
Lansberg MG, O’Donnell MJ, Khatri P, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141:e601S-e636S.
Coutinho JM, Ferro JM, Canha˜o P, et al. Unfractionated or low-molecular weight heparin for the treatment of cerebral venous thrombosis. Stroke 2010;41: 2575-2580.
Stolz E, Trittmacher S, Rahimi A, et al. Influence of recanalization on outcome in dural sinus thrombosis: a prospective study. Stroke 2004;35:544=547.
Baumgartner RW, Studer A, Arnold M, Georgiadis D. Recanalisation of cerebral venous thrombosis. J Neurol Neurosurg Psychiatry 2003;74:459=461.
Strupp M, Covi M, Seelos K, et al. Cerebral venous thrombosis: correlation between recanalization and clinical outcome-a long-term follow-up of 40
patients. J Neurol 2002;249:1123-1124.
Coutinho JM, Ferro JM, Zuurbier SM, et al. Thrombolysis or anticoagulation for cerebral venous thrombosis: rationale and design of the TO-ACT trial. Int J Stroke 2013;8:135-140.
Borhani Haghighi A, Mahmoodi M, Edgell RC, et al. Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review [printed
online ahead of print January 7, 2013].Clin Appl Thromb Hemost 2013. doi:10.1177/1076029612470968.
Zuurbier SM, Coutinho JM, Majoie CB, et al. Decompressive hemicraniectomy in severe cerebral venous thrombosis: a prospective case series. J Neurol 2012;259:1099-1105.
Coutinho JM, Majoie CB, Coert BA, Stam J. Decompressive hemicraniectomy in cerebral sinus thrombosis: consecutive case series and review of the literature. Stroke 2009;40: 2233-2235.
Nasr DM, Brinjikji W, Cloft HJ, et al. Mortality in cerebral venous thrombosis: results from the national inpatient sample database. Cerebrovasc Dis 2013;35:40-44.
Canha˜o P, Cortesa˜o A, Cabral M, et al. Are steroids useful to treat cerebral venous thrombosis? Stroke 2008;39:105-110.
Hanley DF, Feldman E, Borel CO, et al. Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension. Stroke 1988;19: 903-909.
Ferro JM, Lopes MG, Rosas MJ, et al; Cerebral Venous Thrombosis Portuguese Collaborative Study Group. Long-term prognosis of cerebral vein and
dural sinus thrombosis. Results of the VENOPORT study. Cerebrovasc Dis 2002;13:272-278.
Ferro J, Canhao P, Stam J, et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus
Thrombosis (ISCVT). Stroke 2004;35:664-670.
deVeber G, Andrew M, Adams C, et al. Cerebral sinovenous thrombosis in children. N Engl J Med 2001;345:417-423.
Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005;352: 1791-1798.
Crassard I, Bousser MG. Headache in patients with cerebral venous thrombosis [in French]. Rev Neurol (Paris) 2005;161:706-708.
Girot M, Ferro JM, Canha˜o P, et al. Predictors of outcome in patients with cerebral venous thrombosis and intracerebral hemorrhage.Stroke 2007;38:337-342.
Saposnik G, Barinagarrementeria F, Brown R, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals
from the American Heart Association/American Stroke Association.Stroke 2011;42:1158-1192.
Biousse V, Ameri A, Bousser MG. Isolated intracranial hypertension as the only sign of cerebral venous thrombosis. Neurology 1999;53:1537-1542.
Roach ES, Golomb MR, Adams R, et al. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart
Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 2008;39:2644-2691.
Dentali F, Squizzato A, Marchesi C, et al. D-dimer testing in the diagnosis of cerebral vein thrombosis: a systematic review and a meta-analysis of the
literature. J Thromb Haemost 2012;10:582-589.
Hiltunen S, Putaala J, Haapaniemi E, et al. D-dimer and clinicoradiologic features in cerebral venous thrombosis. J Neurol Sci 2013;327:12-14.
Leach MJ, Gall SL, Dewey HM, et al. Factors associated with quality of life in 7-year survivors of stroke. J Neurol Neurosurg Psychiatry 2011;82:1365-1371.
Einha¨ upl K, Bousser MG, de Bruijn SF, et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis. Eur J Neurol 2006;13:553-559.
Leach JL, Fortuna RB, Jones BV, Gaskill-Shipley MF. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics 2006;26:S19-S41.
Selim M, Fink J, Linfante I, et al. Diagnosis of cerebral venous thrombosis with echo-planar T2*-weighted magnetic resonance imaging. Arch Neurol 2002;59:1021-1026.
Bousser, MG, Russell, RR. Cerebral venous thrombosis. In: Warlow, CP, Van Gijn, J editors. Major Problems in Neurology. London, WB Saunders; 1997:27-104.
Sztajzel R, Coeytaux A, Dehdashti AR, et al. Subarachnoid hemorrhage: a rare presentation of cerebral venous thrombosis. Headache 2001; 41:889-891.
Oppenheim C, Domigo V, Gauvrit JY, et al. Subarachnoid hemorrhage as the initial presentation of dural sinus thrombosis. Am J Neuroradiol 2005; 26:614-617.
Spitzer C, Mull M, Rohde V, Kosinski CM. Nontraumatic cortical subarachnoid haemorrhage: diagnostic work-up and aetiological background. Neuroradiology 2005; 47:525-531.
Virapongse C, Cazenave C, Quisling R, et al. The empty delta sign: frequency and significance in 76 cases of dural sinus thrombosis. Radiology 1987;
162:779-785.
Lee EJ. The empty delta sign. Radiology 2002; 224:788-9.
Boukobza M, Crassard I, Bousser MG. When the “dense triangle” in dural sinus thrombosis is round. Neurology 2007; 69:808.
Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis. Continuum (Minneap Minn) 2014;20:335–351.
Wasay M, Azeemuddin M. Neuroimaging of cerebral venous thrombosis. J Neuroimaging 2005;15:118-128.
Ganeshan D, Narlawar R, McCann C, et al. Cerebral venous thrombosis-a pictorial review. Eur J Radiol 2010;74:110-116.
Coutinho JM, Ferro JM, Canha˜o P, et al. Cerebral venous and sinus thrombosis in women. Stroke 2009;40:2356-2361.
Lijfering WM, Brouwer JL, Veeger NJ, et al. Selective testing for thrombophilia in patients with first venous thrombosis: results from a retrospective family cohort
study on absolute thrombotic risk for currently known thrombophilic defects in 2479 relatives. Blood 2009;113:5314-5322.
Martinelli I, Bucciarelli P, Passamonti SM, et al. Long-term evaluation of the risk of recurrence after cerebral sinus-venous thrombosis. Circulation 2010;121:2740-2746.
Einha¨ upl KM, Villringer A, Meister W,et al. Heparin treatment in sinus venous thrombosis. Lancet 1991;338:597-600.
de Bruijn S, Stam J. Randomized,placebo-controlled trial of anticoagulant treatment with low-molecularweight heparin for cerebral sinus thrombosis. Stroke
1999;30:484-488.
Coutinho J, de Bruijn SF, Deveber G, Stam J. Anticoagulation for cerebral venous sinus thrombosis. Cochrane Database Syst Rev 2011;(8):CD002005.
Lansberg MG, O’Donnell MJ, Khatri P, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141:e601S-e636S.
Coutinho JM, Ferro JM, Canha˜o P, et al. Unfractionated or low-molecular weight heparin for the treatment of cerebral venous thrombosis. Stroke 2010;41: 2575-2580.
Stolz E, Trittmacher S, Rahimi A, et al. Influence of recanalization on outcome in dural sinus thrombosis: a prospective study. Stroke 2004;35:544=547.
Baumgartner RW, Studer A, Arnold M, Georgiadis D. Recanalisation of cerebral venous thrombosis. J Neurol Neurosurg Psychiatry 2003;74:459=461.
Strupp M, Covi M, Seelos K, et al. Cerebral venous thrombosis: correlation between recanalization and clinical outcome-a long-term follow-up of 40
patients. J Neurol 2002;249:1123-1124.
Coutinho JM, Ferro JM, Zuurbier SM, et al. Thrombolysis or anticoagulation for cerebral venous thrombosis: rationale and design of the TO-ACT trial. Int J Stroke 2013;8:135-140.
Borhani Haghighi A, Mahmoodi M, Edgell RC, et al. Mechanical thrombectomy for cerebral venous sinus thrombosis: a comprehensive literature review [printed
online ahead of print January 7, 2013].Clin Appl Thromb Hemost 2013. doi:10.1177/1076029612470968.
Zuurbier SM, Coutinho JM, Majoie CB, et al. Decompressive hemicraniectomy in severe cerebral venous thrombosis: a prospective case series. J Neurol 2012;259:1099-1105.
Coutinho JM, Majoie CB, Coert BA, Stam J. Decompressive hemicraniectomy in cerebral sinus thrombosis: consecutive case series and review of the literature. Stroke 2009;40: 2233-2235.
Nasr DM, Brinjikji W, Cloft HJ, et al. Mortality in cerebral venous thrombosis: results from the national inpatient sample database. Cerebrovasc Dis 2013;35:40-44.
Canha˜o P, Cortesa˜o A, Cabral M, et al. Are steroids useful to treat cerebral venous thrombosis? Stroke 2008;39:105-110.
Hanley DF, Feldman E, Borel CO, et al. Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension. Stroke 1988;19: 903-909.
Ferro JM, Lopes MG, Rosas MJ, et al; Cerebral Venous Thrombosis Portuguese Collaborative Study Group. Long-term prognosis of cerebral vein and
dural sinus thrombosis. Results of the VENOPORT study. Cerebrovasc Dis 2002;13:272-278.
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สุขพัลลภรัตน์ ภ. Cerebral Venous Thrombosis: CVT. J Thai Stroke Soc [Internet]. 2019 Feb. 19 [cited 2024 Jul. 1];13(3):69-7. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/173164
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ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
