RESEARCH PAPER
Etiology, clinical manifestation and radiological findings in cerebral venous and sinus thrombosis
 
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1
Department of Radiology in Provincial Hospital No 2 in Rzeszów, Poland
 
2
2nd Department of Radiology, Medical University of Lublin, Poland
 
 
Corresponding author
Anna Solińska   

Department of Radiology in Provincial Hospital No 2 in Rzeszów, Lwowska 60, 35-301 Rzeszów, Poland
 
 
J Pre Clin Clin Res. 2012;6(2):105-110
 
KEYWORDS
ABSTRACT
Introduction:
Cerebral venous sinus thrombosis (CVST) is a rare disease with a variety of symptoms, diagnosed primarily in imaging studies which allow early introduction of proper, causal treatment.

Objective:
To analyze the epidemiological and clinical data and the results of imaging studies performed in patients diagnosed with this disease.

Material and Methods:
The analyzed material consisted of a group of 16 patients (11 women and 5 men) who were examined with CT and MRI in the Department of Radiology and Diagnostic Imaging at Provincial Hospital No. 2, named after St. Jadwiga the Queen, in Rzeszów during the period October 2000 – October 2012, and who were diagnosed with CVST. At least one of the following imaging examination was performed in these patients: head CT scan with or without intravenous contrast administration, CT angiography of the head, head MRI with intravenous contrast agent, MR venography.

Results:
CVST occurred most often in women in two age groups: 20 – 29 and 40 – 49-years-old. The most common risk factors were inflammatory lesions of the head and neck, and slightly less frequent in group of women, oral contraceptives and puerperium. In six patients (37.5%) co-existence of at least two risk factors was observed: 1) thrombotic lesions more often localized in large, paired sinuses, 2) blood clots, observed in multiple locations in the majority of patients, i.e. in 13 patients (81.25%). The greater number of risk factors was associated with a more extensive range of DVT. In eight patients, changes in the sinuses and cerebral veins were associated with various changes in the brain tissue. The level of D-dimers in CVST may be normal. Diagnosis was usually made on the basis of CT angiography examination and, in the second place, on the basis of MR venography.

Conclusions:
CVST is most common in young women. The most common risk factor is inflammation, and puerperium is the condition especially predisposing to parenchymal changes in the brain. The large sinuses are the most common locations for thrombosis. The shorter the duration of clinical symptoms and the more severe their presentation, the more extensive concurrent brain parenchyma changes. The correct level of D-dimers does not exclude the presence of CVST. CT angiography and MR venography are the most sensitive methods for detecting CVST, while MRI with contrast is the most sensitive method to detect parenchymal changes in the brain.

 
REFERENCES (21)
1.
Sapsonik G, Barinagarrementeria F, Brown RD Jr, et al. Diagnosis and management of cerebral venous thrombosis. A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2011; 42(4): 1158-1192.
 
2.
Supeł E, Łęczycka A, Szary C, et al. Septic cerebral sinus thrombosis. Case report. Pol J Radiol. 2009; 74(2): 63‑67.
 
3.
Breteau G, Mounier-Vehier F, Godefory O, et al. Cerebral venous thrombosis. 3-year clinical outcome in 55 consecutive patients. J Neurol. 2003; 250(1): 29‑35.
 
4.
Allroggen H, Abbott RJ. Cerebral venous sinus thrombosis. Postgrad Med J. 2000; 76(891): 12-15.
 
5.
Prakash S, Bansal BC. Cerebral venous thrombosis. J Indian Acad Clin Med. 2000; 5(1): 55‑61.
 
6.
Szurowska E, Szarmach A, Dubaniewicz‑Wybieralska M, et al. Zakrzepica zatok żylnych w badaniach obrazowych (Diagnostic imaging approaches to cerebral sinus venous thrombosis). Udar Mózgu 2009; 11(1): 13‑22 (in Polish).
 
7.
van Gijn J. Cerebral venous thrombosis: pathogenesis, presentation and prognosis. J R Soc Med. 2000; 93: 230‑233.
 
8.
Rodallec MH, Karinik A, Feydy A, et al. Cerebral venous thrombosis and multidetector CT angiography: tips and tricks. Radio Graphics 2006; 26 Suppl 1: 5‑18.
 
9.
Itrat A, Shoukat S, Kamal AK. Patophysiology of cerebral venous thrombosis – an overview. J Pak Med Assoc. 2006; 56(11): 506‑508.
 
10.
Kimber J. Cerebral venous sinus thrombosis. Q J Med. 2002; 95(3): 137-142.
 
11.
Leach JL, Fortuna RB, Jones BV, et al. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radio Graphics, 2006; 26 Suppl 1: 19-43.
 
12.
Linn J, Pfefferkorn T, Ivanicova K, et al. Noncontrast CT in deep cerebral venous thrombosis and sinus thrombosis: comparison of its diagnostic value for both entities. Am J Neuroradiol. 2009; 30(4): 728-735.
 
13.
Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol. 2007; 6(2): 162-170.
 
14.
Walecki J, Bulski T, Sklinda K. Choroby naczynipochodne ośrodkowego układu nerwowego. In: Walecki J. Postępy Neuroradiologii. Polska Fundacja Upowszechniania Nauki, Warszawa, 2007. p. 472‑512.
 
15.
Kozic D, Zarkov M, Semnic RR. Overlooked early CT signs of cerebral venous thrombosis with lethal outcome. Acta Neurol Belg. 2010; 110(4): 345‑348.
 
16.
Crasssard I, Bousser MG. Cerebral venous thrombosis. J Neuro- Ophthalmol. 2004; 24(2): 156-163.
 
17.
Chang R, Friedman DP. Isolated cortical venous thrombosis presenting as subarachnoid hemorrhage: a report of three cases. AJNR Am J Neuroradiol. 2004; 25(10): 1676‑1679.
 
18.
Poon CS, Chang JK, Swarnkar A, et al. Radiologic diagnosis of cerebral venous thrombosis: pictorial review. AJR Am J Roentgenol. 2007; 189(6 Suppl): 64‑75.
 
19.
Crombe D, Haven F, Gille M. Isoalated deep cerebral venous thrombosis diagnosed on CT and MR imaging. A case study and literature review. JBR-BTR, 2003; 86(5): 257-261.
 
20.
Idbaih A, Boukobza M, Crassard I, et al. MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images. Stroke, 2006; 37(4): 991‑995.
 
21.
Boukobza M, Crassard I, Bousser MG, et al. MR imaging features of isolated cortical vein thrombosis: diagnosis and follow-up. AJNR Am J Neuroradiol. 2009; 30(2): 344‑348.
 
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