Etiology, clinical manifestation and radiological findings in cerebral venous and sinus thrombosis
Journal Title: Annals of Agricultural and Environmental Medicine - Year 2012, Vol 6, Issue 2
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 method. 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.
Authors and Affiliations
Anna Solińska, Ewa Dziurzyńska-Białek, Agnieszka Grudzińska-Raczek, Wiesław Guz, Witold Krupski
Keywords
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