Abstract
Cerebral venous thrombosis (CVT) is a rare pathologic condition involving thrombosis of cortical and deep cerebral veins and the dural sinuses. The resultant resistance of venous flow can lead to elevated intracranial pressure, cerebral ischemia, or cerebral hemorrhage. Although poorly understood, the pathogenesis involves a hypercoagulopathic state from any number of systemic conditions. Patients commonly present with headaches or nausea. If hemorrhages occur, symptoms can include focal neurological deficits and strokelike symptoms. In more advanced cases, coma and death can occur. Computed tomography venography or magnetic resonance venography is commonly used to diagnose CVT, although catheter angiography is still considered the “gold standard” diagnostic test. Optimal treatment strategies are still being elucidated with systemic anticoagulation with low-molecular-weight heparin being a mainstay of treatment. Other interventions involving endovascular or systemic thrombolysis or mechanical thrombectomy are being explored. Although historically associated with significant mortality and morbidity, newer studies have suggested a more promising outcome. Among patients who survive, many ultimately make a good recovery with minimal residual neurological symptoms.