Etiology, clinical profile in cortical venous thrombosis

Amar R. Pazare, Karan B Karkera


Background: Cerebral venous sinus thrombosis (CVST) is increasingly recognized entity in young patients due to the widespread availability of MRI and rising clinical awareness. CVST is a multifactorial condition with a wide clinical presentation, variable etiologies and prognosis and it requires high index of suspicion for diagnosis.

Methods: It is an observational prospective study conducted in 57 patients. Patients above 12 years of age with a diagnosis of cerebral venous sinus thrombosis were included in the study to know aetiology, risk factors, clinical presentation and prognosis.

Results: Mean age for males was 40 years and for females it was 36.5 and male to female ratio was 3:2. Headache was the most common symptom (89.47%) followed by convulsions, vomiting, focal neurological deficit, altered sensorium, fever and papilloedema. Superior Sagittal Sinus was the most common sinus involved followed by transverse sinus. Common risk factors were Hyperhomocysteinemia, alcohol, tobacco, APLA syndrome. 52.63% of patients had complete neurological recovery.

Conclusions: CVST is uncommon condition and it is more common in neonates, children and females. The major risk factors for CVT in adults are prothrombotic (hypercoagulable) conditions, oral contraceptives, pregnancy and the puerperium, malignancy, infection, head injury. Headache is the most common symptom may be accompanied by focal neurologic deficits, seizures, and encephalopathy. It carries 5% mortality in the acute phase and 10% over a long-term follow up.


Headache, Magnetic resonance imaging, Prothrombotic conditions

Full Text:



Ferro JM, Canhão P, Stam J. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35:664.

Biousse V, Bousser M-G. Cerebral Venous Thrombosis. Neurol. 1999;5:326-4.

Wasay M, Bakshi R, Kojan S. Nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior sagittal sinus thrombosis. Stroke. 2001;32:2310.

Kim SY, Suh JH. Direct endovascular thrombolytic therapy for dural sinus thrombosis: infusion of alteplase. Am J Neuroradiol. 1997;18:639.

Stam J, Majoie CB, van Delden OM. Endovascular thrombectomy and thrombolysis for severe cerebral sinus thrombosis: a prospective study. Stroke. 2008;39:1487.

Siddiqui FM, Dandapat S, Banerjee C. Mechanical thrombectomy in cerebral venous thrombosis: systematic review of 185 cases. Stroke. 2015;46:1263.

Bousser MG, Chiras J, Bories J, Castagne P. Cerebral venous thrombosis- a review of 38 cases. Stroke. 1985;16:199-213.

Tharaknath VR, Krishna SR, Mukharjee MSS, Babu JM. Ahmed I. Non- gestational cerebral venous thrombosis: a study of 49 cases. Ann Indian Acad Neurol. 2003;6:7-12.

Cumurciuc R, Crassard I, Sarov M. Headache as the only neurological sign of cerebral venous thrombosis: a series of 17 cases. J Neurol Neurosurg Psychiatry. 2005;76:1084.

Kumar S, Alexander M, Gnanamuthu C. Clinical presentation and outcome of postpartum cerebral venous thrombosis. Annals Indn Acad Neurol. 2004;7:448-9.

Ferro JM, Canhão P, Bousser MG. Early seizures in cerebral vein and dural sinus thrombosis: risk factors and role of antiepileptics. Stroke. 2008;39:1152.

Nagaraja D, Tally AB. Progress in Clinical Neurosciences. Ranchi: Sinha publishers; 1988.

Daif A, Awada A, Al-Rajeh S, Abdul Jabbar M, Al Tahan AR, Obeid T, et al. Cerebral venous thrombosis in adults: a study of 40 cases from Saudi Arabia. Stroke. 1995;26:1193-5.

Weih M, Junge-Hülsing J, Mehraein S. Hereditary thrombophilia with ischemic stroke and sinus thrombosis. Diagnosis, therapy and meta-analysis. Nervenarzt. 2000;71:936.

Deschiens MA, Conard J, Horellou MH. Coagulation studies, factor V Leiden, and anticardiolipin antibodies in 40 cases of cerebral venous thrombosis. Stroke. 1996;27:1724.

Lüdemann P, Nabavi DG, Junker R. Factor V Leiden mutation is a risk factor for cerebral venous thrombosis: a case-control study of 55 patients. Stroke. 1998;29:2507.