title: Cerebral venous thrombosis.
abstract: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults and children. In contrast to venous thromboembolism, women are affected three times more often than men. Baseline symptoms can vary considerably between patients, but most present with headache, seizures, or focal neurological deficits. Patients can be diagnosed with magnetic resonance imaging, computerized tomography-venography, or catheter angiography, although the latter is rarely required anymore. Approximately 30-50% of patients have an intracerebral hemorrhage, which can range from a small juxtacortical hemorrhage to large space-occupying lesions. Based on limited evidence from clinical trials, the primary therapy for CVT is anticoagulation with heparin. Uncontrolled studies have shown promising results for the use of endovascular treatment in severely affected patients, but these studies require confirmation in prospective clinical trials. In patients who develop clinical and radiological signs of impending herniation decompressive surgery can be both life saving and result in a good functional outcome.
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Coutinho
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D056424:Decompressive Craniectomy / Q000009:adverse effects; D003952:Diagnostic Imaging / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: cerebral thrombosis; decompressive craniectomy; hemorrhage; heparin; sinus thrombosis; stroke