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Cerebral Venous Sinus Thrombosis

Cerebral venus sinus thrombosis (CVST) occurs when a blood clot forms in the brain’s venous sinuses that prevents blood from draining out of the brain. As a result, blood cells may break and leak blood into the brain tissues, forming a hemorrhage.

This chain of events is part of a stroke that can occur in adults and children, even in newborns and babies in the womb. A stroke can result in damage to the brain and central nervous system. A stroke is serious and requires immediate medical attention.

This condition may also be called cerebral sinovenous thrombosis.

Facts about venous sinus thrombosis

CVST is a rare form of stroke. It affects about five people in 1 million each year. The risk for this kind of stroke in newborns is greatest during the first month. Overall, about three out of 300,000 children and teens up to age 18 will have a stroke.

Children and adults have different risk factors for CVST.

Risk factors for children and infants include:

  • Problems with the way their blood forms clots

  • Sickle cell anemia

  • Chronic hemolytic anemia

  • Beta-thalassemia major

  • Heart disease—either congenital (meaning you're born with it) or acquired (you develop it)

  • Iron deficiency

  • Certain infections

  • Dehydration (not having enough water for your body’s needs)

  • Head injury

  • For newborns, a mother who had certain infections or a history of infertility

Risk factors for adults include:

  • Pregnancy and peripartum

  • Problems with blood clotting; for example, antiphospholipid syndrome, protein C and S deficiency, antithrombin III deficiency, lupus anticoagulant, or factor V Leiden mutation

  • Cancer

  • Collagen vascular diseases like lupus, Wegener’s granulomatosis, and Behcet syndrome

  • Obesity

  • Intracranial hypotension

  • Inflammatory bowel disease like Crohn’s disease or ulcerative colitis

Symptoms

People with venous sinus thrombosis have a variety of symptoms. Responding quickly to these symptoms makes it more possible to recover.

These are the physical symptoms that may occur:

  • Headache

  • Blurred vision

  • Fainting or loss of consciousness

  • Loss of control over movement in part of the body

  • Seizures

  • Coma

Complications of venous sinus thrombosis include:

  • Impaired speech

  • Difficulty moving parts of the body

  • Problems with vision

  • Headache

  • Increased fluid pressure inside the skull

  • Pressure on nerves

  • Brain injury

  • Developmental delay

  • Death

When to call the doctor

People who have had any type of stroke recover best if they get treatment immediately. If you suspect a stroke based on the symptoms, go immediately to the emergency room or call 911 to get help.

Diagnosis

Doctors typically take a medical history and do a physical exam. Family and friends can describe the symptoms they saw, especially if the person who had the stroke is unconscious. The final diagnosis, however, is usually made based on how the blood is flowing in the brain. Imaging tests show areas of blood flow. These tests may be used to diagnose venous sinus thrombosis:

  • MRI scan

  • CT scan

  • Venography

  • Angiography

  • Ultrasound

  • Blood tests

Treatment

Treatment should begin immediately and must be done in a hospital. A treatment plan could include:

  • Fluids

  • Antibiotics, if infections are present

  • Antiseizure medication

  • Monitoring and controlling the pressure inside the head

  • Medication called a coagulant to stop the blood from clotting

  • Surgery

  • Continued monitoring of brain activity

  • Measuring visual acuity and monitoring change

  • Rehabilitation

Prevention

You can do a lot to prevent stroke by leading a heart healthy lifestyle:

  • Eat a low-fat diet including lots of fruits and vegetables.

  • Get daily exercise.

  • Avoid cigarette smoke.

  • Control chronic health conditions, such as diabetes.

Managing after venous sinus thrombosis

What you need to do to recover and then stay healthy after CVST will depend on how the stroke affected your brain. Everyone can benefit from a healthy diet and exercise.

You may also need to participate in a special rehabilitation program or physical therapy if you have lost some movement or speech.

Other possible effects of the stroke, such as headaches or changes in vision, can be treated by specialists.

If you have had this type of stroke, you may need to avoid certain types of medications such as oral contraceptives that can increase your risk for blood clots.

Online Medical Reviewer: Petersen, Sheralee, MPAS, PA-C
Online Medical Reviewer: Weisbart, Ed, MD
Last Review Date: 6/24/2012
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