Cerebral venous thrombosis

Cerebral venous thrombosis is an occlusion of the veins that drain blood in the brain. It is less common than other cerebrovascular diseases such as arterial occlusions (which carry blood to the brain), and can affect young people.

Cerebral venous thrombosis can be caused by transient conditions (infections, pregnancy, dehydration, hormonal drugs) or permanent conditions (inflammatory or hematological diseases, cancer), although in some cases no cause can be found.

SYMPTOMS AND DIAGNOSIS

Symptoms usually present rapidly and progressively over days, although it is variable. It usually causes severe headache with nausea or that worsens when lying down, and may also present seizures, neurological defects (confusion, impaired vision, speech, weakness or sensitivity) or ocular defects (double vision and eye pain).

For diagnosis, neuroimaging tests of the brain and cerebral veins should be performed, which can demonstrate lesions and occlusion of the affected veins. For the study of its causes, blood tests should be performed, and the existence of occult tumors should be evaluated in selected patients.

TREATMENT

First of all, the causes of the venous occlusion should be assessed and treated (e.g. antibiotics in case of infection or change of drugs). In addition, the patient’s symptoms should be treated (e.g. analgesia for headache or anti-crisis drugs in case of seizures).

To remove the existing thrombus in the veins, anticoagulant drugs will be used, which are effective in most cases. In severe cases with poor evolution, other measures can be considered to remove the thrombus with devices that access the inside of the veins.

When should I suspect that someone is suffering from cerebral venous thrombosis?

As in any stroke, you should ask the person to smile (and assess facial asymmetry), to raise his or her arms (observe whether he or she cannot raise them or tends to fall) and to speak (assess whether he or she speaks strangely or cannot be understood). In addition, the patient should be consulted if he/she has an unusual, intense and progressive headache, especially if it is associated with vomiting or worsens when lying down. The existence of painful mental or visual disturbances or a seizure should also be alarm symptoms.

When to go to the emergency room for a stroke?

You should call the emergency service or go to a hospital emergency room immediately whenever there is a sudden and intense neurological alteration or headache.