How much do you know about cerebral venous thrombosis (CVT)?

Cerebral Venous Thrombosis: Epidemiology, Diagnosis, Treatment, and Prognosis

• Cerebral venous thrombosis (CVT) refers to the occlusion of venous channels in the cranial cavity, including dural venous thrombosis, cortical vein thrombosis, and deep cerebral vein thrombosis.
• CVT is a rare condition accounting for approximately 0.5% of all cases of cerebrovascular disease worldwide.
• The clinical presentation of CVT can be highly variable and range from asymptomatic, seizure to coma and death, and may mimic a host of other conditions.
• The pathology of CVT remains poorly understood, but there is an extensive list of known risk factors.
• Unenhanced CT is usually the first imaging investigation performed, relying on hyperdensity of the sinus being identified, while MRI is able to both visualize the clot as well as the sequelae.
• The mainstay of treatment is heparin, even in the setting of hemorrhagic venous infarction.
• The natural history of CVT is highly variable, with some patients having minimal or no symptoms and an uneventful recovery, whereas others have a fulminant course culminating in extensive venous infarction and dependency or death.
• Interventional neuroradiologists can perform catheter-directed thrombolysis by using targeted thrombolytics in the affected sinuses.
• Deep cerebral venous thrombosis also has a negative impact on prognosis due to the usually bilateral involvement of the thalami.
• Dural arteriovenous fistula, increased CSF pressure, and subarachnoid hemorrhage have been reported as possible complications after CVT.
• Filling defects should not be confused with Pacchionian bodies, which can be seen in essentially all dural sinuses and are especially common in the superior sagittal sinus and transverse sinus.
• The relative lack of experienced angiographic skills and invasive nature of the examination has led to a dramatic decline in the use of digital subtraction angiography as a primary mode of diagnosing CVT.

Trombose Venosa Cerebral: Uma Condição Rara e Variável

1. A trombose venosa cerebral (TVC) é uma condição rara que pode levar à obstrução de canais venosos no cérebro, com apresentação clínica variável.
2. A TVC corresponde a aproximadamente 0,5% de todos os casos de doença cerebrovascular no mundo.
3. A apresentação clínica pode variar de assintomática a coma e morte, e pode ser confundida com outras condições.
4. A patogênese da TVC ainda é pouco compreendida, mas há uma lista extensa de fatores de risco.
5. A lesão do volume está relacionada ao desenvolvimento de veias colaterais no segmento venoso afetado.
6. O diagnóstico é feito por meio de exames de imagem, como tomografia computadorizada e ressonância magnética, que podem identificar a presença de trombos.
7. A ressonância magnética é capaz de visualizar tanto o coágulo quanto as sequelas da TVC.
8. O tratamento é baseado no uso de heparina, mesmo em casos de infarto venoso hemorrágico.
9. A evolução da TVC é variável, com alguns pacientes apresentando recuperação completa e outros tendo um curso fulminante com dependência ou morte.
10. A trombólise direcionada por cateter pode ser utilizada em casos graves.
11. A TVC pode levar a complicações como fístula arteriovenosa dural, aumento da pressão do líquido cefalorraquidiano e hemorragia subaracnoidea.
12. A TVC é uma condição complexa e rara, que requer diagnóstico e tratamento adequados para prevenir sequelas e complicações graves.

Test your knowledge on the rare but serious condition of cerebral venous thrombosis (CVT) with this quiz. Learn about the epidemiology, diagnosis, treatment, and prognosis of CVT, including its variable clinical presentation and known risk factors. Explore the imaging investigations used to diagnose CVT and the mainstay of treatment with heparin. Discover the potential complications and negative impact on prognosis, as well as the role of interventional neuroradiologists in targeted thrombolysis. Don't