Cerebral Venous Sinus Thrombosis (CVST)
What is cerebral venous sinus thrombosis?
Cerebral venous sinus thrombosis (CVST) occurs when a blood clot forms in the brain’s venous sinuses. This prevents blood from draining out of the brain. As a result, blood cells may break and leak blood into the brain tissues, forming a hemorrhage.
This chain of events is part of a stroke that can occur in adults and children. It can occur even in newborns and babies in the womb. A stroke can damage the brain and central nervous system. A stroke is serious and requires immediate medical attention.
This condition may also be called cerebral sinovenous thrombosis.
What causes cerebral venous sinus thrombosis?
CVST is a rare form of stroke. It affects about 5 people in 1 million each year. The risk for this kind of stroke in newborns is greatest during the first month. Overall, about 3 out of 300,000 children and teens up to age 18 will have a stroke.
What are the risk factors for cerebral venous sinus thrombosis?
Children and adults have different risk factors for CVST.
Risk factors for children and infants include:
- Problems with the way their blood forms clots
- Sickle cell anemia
- Chronic hemolytic anemia
- Beta-thalassemia major
- Heart disease — either congenital (you're born with it) or acquired (you develop it)
- Iron deficiency
- Certain infections
- Head injury
- For newborns, a mother who had certain infections or a history of infertility
Risk factors for adults include:
- Pregnancy and the first few weeks after delivery
- Problems with blood clotting; for example, antiphospholipid syndrome, protein C and S deficiency, antithrombin III deficiency, lupus anticoagulant, or factor V Leiden mutation
- Collagen vascular diseases like lupus, Wegener’s granulomatosis, and Behcet syndrome
- Low blood pressure in the brain (intracranial hypotension)
- Inflammatory bowel disease like Crohn’s disease or ulcerative colitis
What are the symptoms of cerebral venous thrombosis?
Symptoms of cerebral venous sinus thrombosis may vary, depending on the location of the thrombus. Responding quickly to these symptoms makes it more possible to recover.
These are the physical symptoms that may occur:
- Blurred vision
- Fainting or loss of consciousness
- Loss of control over movement in part of the body
How is cerebral venous sinus thrombosis diagnosed?
People who have had any type of stroke recover best if they get treatment immediately. If you suspect a stroke based on the symptoms, have someone take you immediately to the emergency room, or call 911 to get help.
Doctors typically take a medical history and do a physical exam. Family and friends can describe the symptoms they saw, especially if the person who had the stroke is unconscious. The final diagnosis, however, is usually made based on how the blood is flowing in the brain. Imaging tests show areas of blood flow. These tests may be used to diagnose venous sinus thrombosis:
- MRI scan
- CT scan
- Blood tests
How is cerebral venous sinus thrombosis treated?
Treatment should begin immediately and must be done in a hospital. A treatment plan could include:
- Antibiotics, if an infection is present
- Antiseizure medicine to control seizures if they have occurred
- Monitoring and controlling the pressure inside the head
- Medicine called anticoagulants to stop the blood from clotting
- Continued monitoring of brain activity
- Measuring visual acuity and monitoring change
What are the complications of cerebral venous sinus thrombosis?
Complications of venous sinus thrombosis include:
- Impaired speech
- Difficulty moving parts of the body
- Problems with vision
- Increased fluid pressure inside the skull
- Pressure on nerves
- Brain injury
- Developmental delay
Can cerebral venous sinus thrombosis be prevented?
You can do a lot to prevent stroke by leading a heart healthy lifestyle:
- Eat a low-fat diet, including lots of fruits and vegetables.
- Get daily exercise.
- Avoid cigarette smoke.
- Control chronic health conditions, such as diabetes.
Living with cerebral venous sinus thrombosis
What you need to do to recover and then stay healthy after CVST will depend on how the stroke affected your brain. Everyone can benefit from a healthy diet and exercise.
You may also need to participate in a special rehabilitation program or physical therapy, if you have lost some movement or speech.
Other possible effects of the stroke, such as headaches or changes in vision, can be treated by specialists.
If you have had this type of stroke, you may need to avoid certain types of medicines, such as oral contraceptives. These can increase your risk for blood clots.
Cerebral venous sinus thrombosis (CVST) occurs when a blood clot forms in the brain’s venous sinuses
If you have cerebral venous sinus thrombosis:
- Respond quickly to symptoms like headaches, blurry vision, fainting, losing control of a part of your body, and seizures.
- If you have the above symptoms, have someone take you immediately to the emergency room or call 911 for help.
- Take your medicines as prescribed, and check with your health are provider to make sure that none of your medicines increase your risk of having CVST.
- Educate your loved ones about symptoms of CVST so they can be prepared in an emergency.
- Lead a healthy lifestyle which includes eating a low-fat diet made up mostly of fruits and vegetables, low-fat meats and proteins, low-fat dairy products, and whole-fiber grains, breads, cereals, and pasta.
- Exercise daily and avoid smoking.
Manage your other chronic health issues, such as diabetes or high blood pressure.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
April 01, 2017
Diagnosis and Management of Cerebral Venous Thrombosis. Saposnik G. Stroke. 2011;42(4):1158., Management of Stroke in Infants and Children. Roach ES. Stroke. 2008;39:2644-91., Marx: Rosen's Emergency Medicine. Kwiatkowski T. 2009, 7th ed., pp. 1356-66., Neurosurgery Clinics of North America, July 2010; 21(3-5): 511–527 Nomazulu Dlamini, et al., “Cerebral Venous Sinus (Sinovenous) Thrombosis in Children”
Dozier, Tennille, RN, BSN, RDMS,Shelat, Amit, MD