Cerebrovascular flebothrombosis. A review of a few cases

Abstract

Background: The clinical spectrum of the cerebral vein and dural sinus thrombosis (CVT) is wide and nonspecific. With the development of neuroimaging techniques, their identification recently improved. Objectives: To collect data, identify causes and risk factors, to evaluate treatment and outcome. Patients and methods: 67 patients were admitted between 1998-2008. Their demographic, clinical, radiological data were analysed. The diagnosis was based on MRI+MRA, and/or CT+DSA. Received treatments and outcomes (mRS) were recorded at admission, after 1st and 3rd month, respectively. Results: Sex distribution was: 35 women, 32 men; their average age was 41.92 years; 24 out of 35 women were fertile. The major clinical manifestations included headache, in 40 patients, focal neurological deficit in 8 patients, papilledema in 10 patients. All patients underwent CT, MRI+MRA in 41 patients, DSA in 4 patients. The most frequent thrombosed sinus was superior sagittal sinus (30 patients). Risk factors were identified for 32 patients. After 90 days after admission, death rate was 5.97% (4 patients), and 73.84% made a recovery between 0-2 mRS. Conclusion: CVT were underdiagnosed in our region (low percentage of admissions for benign intracranial hypertension). Even though the percentage of women of fertile age was great, oral contraceptives were not an important risk factor. Diagnostic methods and emergency management were not yet standardized enough, while anticoagulants were systematically used.

Keywords

• cerebral thrombosis
• neuroimaging
• risk factors
• treatment