Objective To investigate the clinical diagnosis and treatment strategy of deep cerebral venous thrombosis (DCVT). Methods A total of 5 DCVT patients were enrolled during the past 10 years. The clinical manifestations, imaging features, treatment and prognosis were retrospectively analyzed. Results DCVT commonly was involved in the internal cerebral veins, vein of Galen, straight sinus, or basal vein of Rosenthal. However, the clinical manifestations of DCVT were atypical. Among patients seen in neurology clinics, headache, disturbance of consciousness, diplopia, and hemiplegia were common manifestations. Oral contraceptives, pregnancy, and puerperium were the common risk factors. Thalamic lesions were the common radiologic sign of DCVT. Heparin offered a simple and effective therapy to prevent blood clots in extended treatment after DCVT, leading to their gradual recovery, with recanalization of the deep venous system. Conclusions The clinical symptoms of DCVT patients are non-specific, and DCVT in the early stages is particularly hard to diagnose. Specific attention should be given to the specific imaging features which could help to diagnose DCVT. The DCVT patients will achieve a better outcome following timely anticoagulant treatment.
Key words
Intracranial deep venous thrombosis /
Basal vein of Rosenthal /
Internal cerebral vein /
Vein of Galen /
Straight sinus /
Imaging /
Treatment
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References
[1] Zuurbier SM, Coutinho JM. Cerebral venous thrombosis[J]. Adv Exp Med Biol, 2017, 906: 183-193.
[2] Ehtisham Aa, Stern BJ. Cerebral venous thrombosis: a review[J]. Neurologist, 2006, 12(1): 32-38.
[3] Bushnell C, Saposnik G. Evaluation and management of cerebral venous thrombosis[J]. Continuum (Minneap Minn), 2014, 20 (2 Cerebrovacular Disease): 335-351.
[4] Stam J. Thrombosis of the cerebral veins and sinuses[J]. N Engl J Med, 2005, 352(17): 1791-1798.
[5] Weimar C, Masuhr F, Hajjar K. Diagnosis and treatment of cerebral venous thrombosis[J]. Expert Rev Cardiovasc Ther, 2012, 10(12): 1545-1553.
[6] Ferro JM, Canhão P, Stam J, et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) [J]. Stroke, 2004, 35(3): 664-670.
[7] Schaller B, Graf R. Cerebral venous infarction: the pathophysiological concept[J]. Cerebrovasc Dis, 2004, 18(3): 179-188.
[8] Coutinho JM, Stam J, Canhão P, et al. Cerebral venous thrombosis in the absence of headache[J]. Stroke, 2015, 46(1): 245-247.
[9] van den Bergh WM, van der Schaaf I, van Gijn J. The spectrum of presentations of venous infarction caused by deep cerebral vein thrombosis[J]. Neurology, 2005, 65(2): 192-196.
[10]Kumar P, Sasmal G, Mahto SK, et al. Deep cerebral vein thrombosis: a clinical masquerader[J]. J Clin Diag Res, 2017, 11(4): OD16-OD18.
[11]Meder JF, Chiras J, Roland J, et al. Venous territories of the brain[J]. J Neuroradiol, 1994, 21(2): 118-133.
[12]李世清, 王守森. 颅内静脉窦与相关静脉的解剖及影像学意义[J]. 中国临床解剖学杂志, 2013, 31(2): 229-231.
[13]Ferro JM, Canhão P, Aguiar de Sousa D. Cerebral venous thrombosis[J]. Presse Med, 2016, 45(12 Pt 2): e429-e450.
[14]Ayanzen RH, Bird CR, Keller PJ, et al. Cerebral MR venography: normal anatomy and potential diagnostic pitfalls[J]. AJNR Am J Neuroradiol, 2000, 21(1): 74-78.
[15]Menon D, Sarojam MK, Gopal R. Unilateral thalamic infarct: a rare presentation of deep cerebral venous thrombosis[J]. Ann Indian Acad Neurol, 2019, 22(2): 221-224.
[16]王凡, 姚国刚, 杨顺生, 等. 大脑深部静脉循环代偿能力的形态学分析[J]. 中国临床解剖学杂志, 1997, 15(3): 187-190.
[17]Ferro JM, Bousser MG, Canhão P, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis-endorsed by the European Academy of Neurology[J]. Eur J Neurol, 2017, 24(10): 1203-1213.
