venous sinus thrombosis
| Headline | |
|---|---|
| Etiology | cavernous sinus thrombosis, dural sinus, deep cerebral vein... - infection/inflammation e.g. sinusitis → cavernous sinus - acquired prothrombotic states e.g. nephrotic syndrome, pregnancy, dehydration - autoimmune e.g. sarcoidosis, SLE, Behcet's - drugs - congenital prothrombotic states e.g. Factor V Leiden mutation, antiphospholipid... |
| Epidemiology | F>M (3:1), 80% age <50 Makes up 1% of all strokes Risk factors: prothrombotic, steroids, hormonal (oral contraception) |
| Clinical presentation | headache (88%, Ferro et al 2004), vision changes, N+V +/- focal neurology, seizures |
| Pathogenesis | vascular congestion → vasogenic oedema? |
| Diagnostic investigations | CT venogram Pregnancy test! +/- Thrombophilia screen |
| Management | anticoagulation - prevent progression to venous infarction |
sources/links
https://litfl.com/ct-case-071/
https://litfl.com/cerebral-venous-thrombosis/
https://derangedphysiology.com/main/required-reading/neurological-intensive-care/Chapter-154/cerebral-venous-sinus-thrombosis
https://www.ahajournals.org/doi/full/10.1161/01.str.0000117571.76197.26
US guidelines - https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000456