What Is Cerebral Venous Sinus Thrombosis?
Cerebral venous sinus thrombosis (CVST) is a special type of cerebrovascular disease with an incidence of less than 1% of all strokes. It is more common in children and young adults, and in children, lateral sinuses and cavernous sinuses are common. Patients with suppurative otitis media and mastoiditis are prone to thrombosis of the transverse portion of lateral sinus and sigmoid portion of lateral sinus, collectively referred to as lateral sinus thrombosis. According to the nature of the lesion, CVST can be divided into two types: inflammatory and non-inflammatory. Cavernous sinus and transverse sinus are the most commonly affected sites in the inflammatory type. The non-inflammatory middle and superior sagittal sinuses are most susceptible. Transsinus sigmoid sinus thrombosis is often secondary to suppurative mastoiditis or otitis media.
Cerebral venous sinus thrombosis
Cerebral venous sinus thrombosis
- Cerebral venous sinus thrombosis (CVST) is a special type of cerebrovascular disease with an incidence of less than 1% of all strokes. It is more common in children and young adults, and in children, lateral sinuses and cavernous sinuses are common. Patients with suppurative otitis media and mastoiditis are prone to thrombosis of the transverse portion of lateral sinus and sigmoid portion of lateral sinus, collectively referred to as lateral sinus thrombosis. According to the nature of the lesion, CVST can be divided into two types: inflammatory and non-inflammatory. Cavernous sinus and transverse sinus are the most commonly affected sites in the inflammatory type. The non-inflammatory middle and superior sagittal sinuses are most susceptible. Transsinus sigmoid sinus thrombosis is often secondary to suppurative mastoiditis or otitis media.
- In order to better understand the clinical symptoms and signs of CVST, we should first distinguish between two different pathophysiological mechanisms. That is, cerebral venous thrombosis-a focal symptom caused by venous obstruction; cerebral venous sinus thrombosis-intracranial hypertension caused by venous sinus thrombosis. In most patients, these two pathophysiological processes often coexist. Occlusion of cerebral veins produces local cerebral edema and venous infarction. Pathological examination can reveal enlarged, swollen veins, edema (including cytotoxic edema and vasogenic edema), ischemic neuronal damage, and spotted bleeding. The latter can be fused into a large hematoma and detected by CT. Transverse sinus sigmoid sinus thrombosis can lead to increased venous pressure, which affects the absorption of cerebrospinal fluid and produces intracranial hypertension. Because it affects the final pathway of cerebrospinal fluid circulation, there is no pressure gradient between the subarachnoid space and the ventricle, so the ventricle does not dilate and it does not cause hydrocephalus in all patients.
Clinical manifestations of cerebral venous sinus thrombosis
- Common common clinical manifestations are:
- 1. Symptoms of increased intracranial pressure: persistent and severe headache, jet vomiting, or visible papillary edema.
- 2. Symptoms of stroke: Multiple small bleeding is common.