Cerebral venous thrombosis

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By David S Liebeskind MD

Cerebral venous thrombosis is also known as or subsumes Cavernous sinus thrombosis, Cortical vein thrombosis, Lateral sinus thrombosis, and Superior sagittal sinus thrombosis. -ed.

Cerebral venous thrombosis is a rare but important cause of stroke that is often missed or delayed in diagnosis. Dr. David S Liebeskind, Professor of Neurology, Neurology Director of Stroke Imaging, and Associate Neurology Director of the UCLA Stroke Center provides a clinical article reflecting the most recent literature on the topic. The clinical manifestations are myriad, and a high level of suspicion must be maintained in order to effectively and expeditiously identify this disorder. Infectious and noninfectious processes may cause cerebral venous thrombosis. In adults, about half of cases are associated with pregnancy and the puerperium, but numerous unusual etiologies must be considered in the remainder of patients. Anticoagulation is the mainstay of therapy in the presence of either ischemic or hemorrhagic stroke; in some dire cases, more aggressive approaches such as thrombolysis or mechanical clot disruption may be undertaken.

Key Points

  • Cerebral venous thrombosis is associated with an extensive range of medical disorders.
  • Treatment is primarily focused on thrombus resolution, with either anticoagulation or endovascular approaches in cases with rapid neurologic deterioration.
  • Intracerebral hemorrhage due to cerebral venous thrombosis is not necessarily a cause to withhold anticoagulation.