Cerebral Venous Sinus Thrombosis

Thrombosis of the venous sinuses leading to:

Epidemiology and Risk Factors

Pathophysiology

Aetiology

Causes include:

  • Infection
    Classical cause.
    • Intracranial
      • Meningitis
      • Epidural abscess
      • Subdural abscess
    • Extracranial
      • Facial cellulitis
      • Dental infection
  • Prothrombotic cause
    • OCP
    • Hereditary

Clinical Manifestations

Diagnostic Approach and DDx

Investigations

Bedside:

Laboratory:

Imaging:

  • CT
    Sensitivity 60%, or 96%.
  • MRI or MRA
    Sensitivity 86%/96% respectively.
  • DSA
    100% sensitive.

Other:

Management

Principles are:

  • Treat primary infection
  • Anticoagulation
    There is often concurrent intracerebral haemorrhage, and this is not a contraindication to anticoagulation.

Resuscitation:

ABC approach. Comment on team coordination and clinical priorities. Specific therapy:

  • Pharmacological
  • Procedural
  • Physical

Supportive care:

Disposition:

Preventative:

Marginal and Ineffective Therapies

Anaesthetic Considerations

Complications

Prognosis

Key Studies

References

  1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.