Cerebral venous thrombosis

Variable expression: The clinical expression of cerebral venous thrombosis varies widely. The only manifestation may be an intracranial hypertension i f the thrombus is limited to the superior longitudinal sinus or a predomina nt lateral sinus. Thrombosis of cortical veins, alone or in association wit h a sinus thrombus causes venous infarction. Prognisis: Deep venous thrombosis generally leads to coma with signs of int racranial hypertension. However, partial or complete recovery is possible, even with a severe initial presentation, underlining the importance of earl y diagnosis and treatment. Diagnostic methods: Magnetic resonance imaging (MRI) coupled with magnetic resonance angiography (MRA) can usually confirm the diagnosis without conve ntional angiography. Etiological diagnosis: Cerebral venous thrombosis often follows prethrombot ic conditions. Infectious causes only account for 10% of the cases and no c ause can be identified in about 1 out of 5 cases. Treatment: Anticoagulation is indicated even in case of venous infarction w ith spontaneous bleeding. Thrombolysis can be proposed, particularly for de ep venous thrombosis.