Cerebral venous thromboses
Masson, C.; Colombani, J.M.
Presse Medicale 28(28): 1547-1552
1999
ISSN/ISBN: 0755-4982 PMID: 10526566 Document Number: 505082
VARIABLE EXPRESSION: The clinical expression of cerebral venous thrombosis varies widely. The only manifestation may be an intracranial hypertension if the thrombus is limited to the superior longitudinal sinus or a predominant lateral sinus. Thrombosis of cortical veins, alone or in association with a sinus thrombus causes venous infarction. Deep venous thrombosis generally leads to coma with signs of intracranial hypertension. However, partial or complete recovery is possible, even with a severe initial presentation, underlining the importance of early diagnosis and treatment. Magnetic resonance imaging (MRI) coupled with magnetic resonance angiography (MRA) can usually confirm the diagnosis without conventional angiography. ETIOLOGICAL DIAGNOSIS: Cerebral venous thrombosis often follows prethrombotic conditions. Infectious causes only account for 10% of the cases and no cause can be identified in about 1 out of 5 cases. Anticoagulation is indicated even in case of venous infarction with spontaneous bleeding. Thrombolysis can be proposed, particularly for deep venous thrombosis.