User:Mr. Ibrahem/Cerebral venous sinus thrombosis
| Cerebral venous sinus thrombosis | |
|---|---|
| Other names | Cerebral venous thrombosis, cerebral venous and sinus thrombosis, (superior) sagittal sinus thrombosis, dural sinus thrombosis, intracranial venous thrombosis, cerebral thrombophlebitis, cerebral sinovenous thrombosis[1] |
 | |
| Dural veins | |
| Specialty | Neurology |
| Symptoms | Headache, abnormal vision, stroke symptoms, seizures[2] |
| Complications | Subarachnoid bleed[2] |
| Types | Acute, subacute, chronic[2] |
| Risk factors | Hereditary thrombophilia, birth control, pregnancy, head and neck infections, vasculitis, cancer, dehydration, obesity[2] |
| Diagnostic method | MRI, CT scan[2] |
| Treatment | Heparin (low molecular weight or unfractionated)[2] |
| Prognosis | 12% moderate to severe disability[3] |
| Frequency | Relatively rare[2] |
| Deaths | 9.4%[3] |
Cerebral venous sinus thrombosis (CVST) is the presence of a blood clot in the dural venous sinuses, which drain blood from the brain.[1] Symptoms may include headache, abnormal vision, symptoms of a stroke such as weakness of the face and limbs on one side of the body, and seizures.[2] Complications may include a subarachnoid bleed.[2]
Risk factors are present about 85% of people and include hereditary thrombophilia, birth control, pregnancy, head and neck infections, vasculitis, cancer, dehydration, and obesity.[2] Diagnosis is usually by computed tomography (CT scan) or magnetic resonance imaging (MRI).[4] The transverse sinus and superior sagittal sinus are most commonly involved in 86% and 62% of cases respectively.[2] It is divided into three types based on the time from symptom onset: acute (less than 48 hours), subacute (48 hours to one month), and chronic (greater than one month).[2] Testing may be done to try to determine the underlying cause.[2]
Treatment is typically with anticoagulants (medication that suppresses blood clotting), specifically low molecular weight heparin (LMWH) or unfractionated heparin.[5][2] LMWH is generally preferred.[2] Treatment is generally for 3 to 12 months following a first event.[2] Rarely, thrombolysis (enzymatic destruction of the blood clot) is used.[2] The disease may be complicated by raised intracranial pressure, which may be treated with acetazolamide, lumbar puncture, or surgical placement of a shunt.[2] The disease may recur in up to 3% of cases.[2]
Cerebral venous thrombosis is relatively rare.[2] Between 3 and 40 people per million are affected.[2] Rates in women are about 3 fold those in men.[2] Of people who develop a stroke, CVST is the underlying cause in about 1%.[2] Death occurs in about 9.4% of those affected.[3] The condition was first described by the French physician Ribes in 1825.[6][7]
References[edit]
- ^ a b "Cerebral Venous Sinus Thrombosis (CVST)". www.hopkinsmedicine.org. Retrieved 26 September 2020.
- ^ a b c d e f g h i j k l m n o p q r s t u v w Idiculla, PS; Gurala, D; Palanisamy, M; Vijayakumar, R; Dhandapani, S; Nagarajan, E (2 September 2020). "Cerebral Venous Thrombosis: A Comprehensive Review". European neurology: 1–11. doi:10.1159/000509802. PMID 32877892.
- ^ a b c Dentali, Francesco; Gianni, Monica; Crowther, Mark A.; Ageno, Walter (15 August 2006). "Natural history of cerebral vein thrombosis: a systematic review". Blood. 108 (4): 1129–1134. doi:10.1182/blood-2005-12-4795.
- ^ Stam J (2005). "Thrombosis of the cerebral veins and sinuses". N. Engl. J. Med. 352 (17): 1791–8. doi:10.1056/NEJMra042354. PMID 15858188.
- ^ Al Rawahi, B; Almegren, M; Carrier, M (September 2018). "The efficacy and safety of anticoagulation in cerebral vein thrombosis: A systematic review and meta-analysis". Thrombosis Research. 169: 135–139. doi:10.1016/j.thromres.2018.07.023. PMID 30056293.
- ^ Misra, U. K.; Kalita, J. (2010). Diagnosis & Management of Neurological Disorders. Wolters kluwer india Pvt Ltd. p. 325. ISBN 978-81-8473-191-0. Retrieved 26 September 2020.
- ^ Ribes MF (1825). "Des recherches faites sur la phlebite". Rev. Med. Fr. Etrang. 3: 5–41.