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Cerebral venous sinus thrombosis (CVST), cerebral venous and sinus thrombosis or cerebral venous thrombosis (CVT), is the presence of a blood clot in the dural venous sinuses (which drain blood from the brain), the cerebral veins, or both.
The dural venous sinuses (also called dural sinuses, cerebral sinuses, or cranial sinuses) are venous sinuses (channels) found between the periosteal and meningeal layers of dura mater in the brain. [ 1 ] [ 2 ] They receive blood from the cerebral veins , and cerebrospinal fluid (CSF) from the subarachnoid space via arachnoid granulations .
The dural venous sinuses drain blood from the brain to the internal jugular veins, which in turn drains blood to the heart. It has been proposed that the empty delta sign occurs in dural venous thromboses due to contrast material filling the dural venous collateral circulation immediately surrounding the dura whilst being unable to fill the ...
Dural venous sinus thrombosis (DVST) and cortical venous thrombosis (CVT) commonly presents with headache, increased intracranial pressure, or seizures. DVST is more common than CVT. DVST are frequently caused by infections in the skull base, dehydration, thrombophilia, meningioma, and other dural tumours. [3]
Management of cranial venous outflow obstruction involves treating the underlying cause, if identifiable, and managing the symptoms. This can include medication to reduce intracranial pressure, anticoagulation therapy to prevent thrombosis, and in some cases, surgical intervention to restore normal venous drainage. [6] [11]
An MR venogram is also performed in most cases to exclude the possibility of venous sinus stenosis/obstruction or cerebral venous sinus thrombosis. [5] [7] [8] A contrast-enhanced MRV (ATECO) scan has a high detection rate for abnormal transverse sinus stenoses. [15]
Type III dural fistulas need to be treated to prevent hemorrhage. Treatment can be as simple as clipping the draining vein at the site of the dural sinus. If treatment involves embolization, it will only typically be effective if the glue traverses the actual fistula and enters, at least slightly, the draining vein. [citation needed]
The confluence of sinuses (Latin: confluens sinuum), torcular Herophili, or torcula is the connecting point of the superior sagittal sinus, straight sinus, and occipital sinus. It is below the internal occipital protuberance of the skull. It drains venous blood from the brain into the transverse sinuses.