Abstract
Cerebral venous sinus thrombosis is a rare cause of stroke with a variable clinical presentation and potentially fatal outcomes secondary to venous hypertension. Headache is the most common presenting symptom and a high index of clinical suspicion is required to ensure timely diagnosis via computed tomograpy venogram (CTV)/MRV. Anticoagulation with LMWH or UFH is recommended in the acute phase even in the presence of intracerebral hemorrhage in order to prevent thrombus progression, promote recanalization, and decrease venous congestion. Transition to oral anticoagulation is recommended with the duration of treatment dependent on risk factors, clinical history, and underlying etiology of CVT in order to prevent progressive and recurrent thromboembolic events. Sequela associated with CVT such as seizures and intracranial hypertension needs to be treated in order to prevent further neurological injury. For patients with persistent neurological decline or failure of systemic anticoagulation therapy, endovascular techniques such as catheter-directed thrombolysis and mechanical thrombectomy have emerged as successful treatment options. Patients with significant associated mass effect may require life-saving decompressive craniectomy. Despite these treatment options, CVT may result in significant morbidity and mortality. As a result, there remains significant room for continued studies to further define optimal management strategies for CVT.
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Quach, E., Kaul, A., Almefty, R.O. (2022). Sinus Thrombosis. In: Mascitelli, J.R., Binning, M.J. (eds) Introduction to Vascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-88196-2_18
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