Cerebral venous thrombosis

Refers to the formation of thrombus in the cerebral veins and in the venous sinuses.

Frequency of diagnosis is increasing due to the presence of MRI.

Approximate worldwide incidence is five people per million per year and accounts for 0.5-3% of all stroke.

Female predominance with the ratio of 3 to 1.


It is most common in individuals younger than age 50. 

Cerebral venous sinus thrombosis accounts for ~1% of cases of stroke.

More common in women, because pregnancy and the puerperal period place women at increased risk.

Signs and symptoms of CVST are diverse and the diagnosis may be elusive. However, diagnosis is important because treatment may significantly reduce morbidity and mortality.

Risk factors include oral contraceptives, genetic prothrombotic tendencies, pregnancy, postpartum status, infections, malignancy, and trauma.

Identifiable risk factors are present in approximately 80 to 85% of patients.

Patients may present with acute or chronic progressive headaches, papilledema, transient visual abnormalities, seizures, focal neurologic signs or subacute encephalopathy.

The most common complaint is headache with greater than 90% of patients presenting with headache.

Other symptoms can include nausea, vomiting, visual disturbance, papilledema, focal or generalized seizures, focal neurological deficits, altered mental status and coma.

The variety of symptoms that present relates to multiple pathological underlying processes and the location of the thrombus

Clinical findings or dependent on the location and extent of thrombus.

Cerebral venous thrombosis causes an obstruction of the normal venous drainage, leading to venous congestion, which causes edema, ischemia, infarction, and hemorrhage.

A thrombus in the venous sinuses causes increased intracranial pressure by impairing drainage and absorption of CSF.

Increased intracranial pressure is found in 30 to 40% of patients with CVT.

Brain MRI may show infarct, hemorrhage or thrombosis.

Magnetic resonance venography may show a lack of signal.

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