Neurology

Cerebral venous sinus thrombosis

Cerebral venous sinus thrombosis is thrombosis of a dural venous sinus or cerebral vein that obstructs venous drainage, causing raised intracranial pressure, venous infarction, haemorrhage, seizures and focal or diffuse neurological dysfunction.

Definition

Cerebral venous sinus thrombosis is thrombotic occlusion of an intracranial dural venous sinus, cerebral vein or both. It obstructs venous and cerebrospinal-fluid drainage, producing raised intracranial pressure, venous oedema, venous infarction and sometimes secondary haemorrhage.

First principles

A drainage problem, not an arterial supply problem

A thrombus in a dural sinus or cortical vein impairs venous drainage. Venous pressure rises, cerebrospinal-fluid absorption falls and congested tissue develops oedema or venous infarction. The resulting lesion may cross arterial territories and is often haemorrhagic, so haemorrhage caused by venous congestion does not remove the indication for anticoagulation.

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