Cerebral Venous Sinus Thrombosis

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon diagnosis affecting as many as 15.7 patients per million people per year. It affects females more common than males with a ratio of 3:1, and in the majority of cases, there is a predisposing hypercoagulable state or less commonly an underlying cause such as trauma or infection. The clinical manifestation is extremely varied, but common presenting symptoms, such as headache and seizures, can often be nonspecific. Similarly, the natural history of cerebral venous sinus thrombosis varies widely from a benign self-limiting process to intracerebral hemorrhage and death. An ongoing study on the pathogenesis of cerebral venous sinus thrombosis has implicated in the development of dural arteriovenous fistulas. These potentially disastrous outcomes highlight the need for quick, accurate diagnosis and prompt management. Though the mainstay of therapy for venous sinus thrombosis remains systemic anticoagulation, there is increasing evidence to support early and aggressive endovascular treatment with catheter-directed thrombolysis and/or mechanical thrombectomy. As with most cerebrovascular disorders, cerebral venous sinus thrombosis management is best guided by a multidisciplinary team of providers including neurologists, neurosurgeons, and neuroradiologists, with a treatment plan tailored to the individual patient.