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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 .
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 ]
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]
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 intra-dural sinus space due to the presence of a blood clot. [2] The superior sagittal sinus is most commonly affected, but the ...
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]
While venous thrombosis of the legs is the most common form, venous thrombosis may occur in other veins. These may have particular specific risk factors: [5] Cerebral venous sinus thrombosis, cavernous sinus thrombosis and jugular vein thrombosis: thrombosis of the veins of the brain and head
Subdural hematomas grow continually larger as a result of the pressure they place on the brain: As intracranial pressure rises, blood is squeezed into the dural venous sinuses, raising the dural venous pressure and resulting in more bleeding from the ruptured bridging veins. They stop growing only when the pressure of the hematoma equalizes ...