Cerebral Venous Thrombosis

Etiology

Infection

  • Mucormycosis (see Mucormycosis, [[Mucormycosis]])
  • Sinusitis (see Sinusitis, [[Sinusitis]])
    • Extension of infection from the paranasal sinuses may result in subdural empyema, cerebral venous thrombosis, and/or bacterial meningitis
    • Frontal Sinusitis: most common source of infection (via spread through emissary veins between the posterior sinus mucosa and the meninges)
    • Sphenoid Sinusitis: may result in cavernous sinus thrombosis

Trauma/Surgery

  • Head Trauma
  • Dural Taps
  • Infusions into Internal Jugular Vein

Hypercoagulable States (see Hypercoagulable States, [[Hypercoagulable States]])

  • Anti-Phospholipid Antibody Syndrome (see Anti-Phospholipid Antibody Syndrome, [[Anti-Phospholipid Antibody Syndrome]])
  • Anti-Annexin A2 Antibodies: annexin A2 is a fibrinolytic receptor
  • Antithombin III Deficiency (see xxxx, [[xxxx]])
  • Factor V Leiden Mutation (see Factor V Leiden, [[Factor V Leiden]])
  • Hyperhomocysteinemia (see Hyperhomocysteinemia, [[Hyperhomocysteinemia]]): strong risk factor for cerebral venous thrombosis (being present in 27-43% of patients with cerebral venous thrombosis)
  • Malignancy
  • Pregnancy/Puerperium (see Pregnancy, [[Pregnancy]])
  • Protein C Deficiency (see xxxx, [[xxxx]])
  • Protein S Deficiency (see xxxx, [[xxxx]])

Rheumatologic

  • Behcet’s Disease (see xxxx, [[xxxx]])
  • Systemic Lupus Erythematosus (SLE) (see xxxx, [[xxxx]])
  • Wegener’s Granulomatosis (see xxxx, [[xxxx]])

Drugs

  • Corticosteroids (see xxxx, [[xxxx]])
  • Epsilon Aminocaproic Acid (Amicar) (see Epsilon Aminocaproic Acid, [[Epsilon Aminocaproic Acid]])
  • Erythropoitein (see xxxx, [[xxxx]])
  • Heparin-Induced Thrombocytopenia (HIT) (see Heparin-Induced Thrombocytopenia, [[Heparin-Induced Thrombocytopenia]])
  • L-Asparaginase (see L-Asparaginase, [[L-Asparaginase]])
  • Oral Contraceptives (OCP) (see xxxx, [[xxxx]]): including third generation formulations
  • Phytoestrogens
  • Tamoxifen (see xxxx, [[xxxx]])
  • Thalidomide (see xxxx, [[xxxx]])

Other

  • Cirrhosis (see End-Stage Liver Disease, [[End-Stage Liver Disease]])
  • Dehydration
  • High Altitude (see xxxx, [[xxxx]])
  • Inflammatory Bowel Disease
    • Crohn’s Disease
    • Ulcerative Colitis
  • Lumbar Puncture: case reports of cerebral venous thrombosis after lumbar puncture (possibly related to decreased smean blood velocity in straight sinus
  • Nephrotic Syndrome (see xxxx, [[xxxx]])
  • Paroxysmal Nocturnal Hemoglobinuria (PNH) (see xxxx, [[xxxx]])
  • Polycythemia (see xxxx, [[xxxx]])
  • Sarcoidosis (see Sarcoidosis, [[Sarcoidosis]])
  • Sickle Cell Disease (see xxxx, [[xxxx]])
  • Spontaneous Intracranial Hypotension: cerebral venous thrombosis is present in only 2.1% of patients with spontaneous intracranial hypotension
  • Thrombotic Thrombocytopenic Purpura (TTP) (see xxxx, [[xxxx]])

Site of Thrombosis

  • Cavernous Sinus Thrombosis
  • xxx

Diagnosis

  • Head CT:
  • Brain MRI/MRA:

Clinical Manifestations

Neurologic Manifestations

  • Headache (see Headache, [[Headache]])
  • Increased Intracranial Pressure (ICP) (see Increased Intracranial Pressure, [[Increased Intracranial Pressure]]): with sagittal sinus thrombosis -> obstructed cerebral venous outflow

Treatment

  • Anticoagulation:
  • xxx

References

  • xxx