Cerebral Venous Thrombosis : Causes, Symptoms, Treatment, Diagnosis

Cerebral venous thrombosis is a condition in which a blood clot forms in the brain. This causes the leaking of blood into the brain tissue. It is also known as cerebral venous sinus thrombosis. It is a rare condition and is known to have an annual occurrence rate of 3-4 cases per million people.⁽¹⁾

Cerebral veins are the blood vessels that play the role of draining blood out of the brain. These are connected with the dural sinus, the blood channels that transport blood back to the heart.

If not treated cerebral venous thrombosis can even lead to death.

There are several causes of cerebral venous thrombosis. According to the American Heart Association cerebral venous thrombosis occurs in children due to infections such as sinusitis or tonsillitis.⁽²⁾

The cause in adults include:⁽⁴⁾

• Head trauma
• Oral contraceptives
• Infection of the ear, sinus, mouth, and nose
• Lupus
• Behcet’s disease, a condition causing blood inflammation
• Surgery
• Neurosurgery
• Neurosarcoidosis, inflammation of the nervous system
• Malignancy
• Prothrombotic genetic or acquired condition such as protein C or S deficiency

It has been researched that females suffer from cerebral venous thrombosis more than males.⁽³⁾ The other risk factors include:

• Vascular abnormalities
• Postpartum status
• Hormone replacement therapy
• Genetic conditions including antiphospholipid syndrome and nephrotic syndrome
• Drugs including lithium, vitamin A, ecstasy, and intravenous immunoglobin

The symptoms of cerebral venous thrombosis may vary from person to person. 90% of people experience headaches, which are similar to migraine but may increase in severity over a few days. The symptoms can also be sudden and very severe.

Vomiting, nausea, eye pain, and irritation are also symptoms of cerebral venous thrombosis.

The other symptoms of cerebral venous thrombosis include:

• Fever, in cases where the cause is an infection
• Partial weakness or paralysis
• Loss of balance or coordination
• Blurred vision
• Coma
• Seizure
• Protruding eyeballs
• Altered brain function
• Difficulty with speech and coordination
• Stroke
• Loss of sensation on one side of the brain

For diagnosing cerebral venous thrombosis, healthcare professionals may order neuroimaging scans, which include:

• Magnetic resonance imaging (MRI): Magnetic fields and radio waves are used to get a detailed picture of the inside of the body. Doctors may use MRV scans instead of MRI scans. It involves injecting a special dye into the person’s blood vessels, which helps in showing up the area of blockage.
• Computerized tomography scans (CT): In this, X-rays are used to create images of a cross-section of a person’s body.

The treatment options for cerebral venous thrombosis include:

• Medication: A review found that anticoagulation therapy is the most common treatment for cerebral venous thrombosis.⁽³⁾ Heparin is an anticoagulant that can be helpful in preventing blood clotting in a person.
• Thrombolysis: It is a procedure that is helpful in breaking up blood clots inside a person’s blood vessel. For cerebral venous thrombosis, the doctor recommends catheter-directed thrombolysis. It is a procedure in which a healthcare professional inserts a catheter into a person’s blood vessel and delivers clot-busting medication directly into the clot.
• Surgery: Surgery is recommended if the other treatment options are not effective. It involves the removal of the clot and the repairing of the vein. Additional treatment is given to the person for the cause of cerebral venous thrombosis.

Cerebral venous thrombosis is easier to treat if diagnosed sooner. Without treatment, it may lead to stroke, coma, permanent disability, and death.

Anyone with cerebral venous thrombosis should seek immediate medical help as it needs treatment as quickly as possible. After the treatment is done, warfarin should be taken as it helps in preventing blood clots. Lifelong treatment may be needed for those with recurrent cerebral venous thrombosis. Those having frequent headaches along with other symptoms of cerebral venous thrombosis should see a doctor for proper diagnosis and appropriate treatment.