Cerebral venous thrombosis Flashcards
what is cerebral venous thrombosis?
thrombotic obstruction of cerebral venous system that may lead to ischameic or haemorrhagic lesions
men or women?
more women
risk factors
prothrombotic conditions, pregnancy, COCP, malignancy and infection
typical presenting feature
headache
what may develop as CVT progresses?
focal neurological deficits
seizures
raised ICP
diagnosis
CT and MRi with radiocontrast
dural sinuses
valveless venous channels between 2 layers of dura mater which drain blood from brain into IJV
ophthalmoscopy
papilloedema
clinical features
headache, N&V, CN symptoms eg diplopia, facial palsy
focal seizures
cavernous sinus syndrome
A condition caused by compression of the cranial nerves that pass through the cavernous sinus (i.e., III, IV, V1, and V2). Symptoms include ophthalmoplegia, conjunctival congestion, proptosis, sensory loss on the forehead and cheek (trigeminal area), and Horner syndrome
first steps of diagnosis
D-dimers
CT/MRI
other tests
ESR, antibodies, CRP, clotting
EEG
initial management
control seizures
fluids
antithrombotic therapy
surgical options
blood clot removal
vessel recanalisation
shunt placement
reducing ICP
therapeutic LP
mannitol
position of patient
