<aside>
CVST is a rare but potentially life-threatening condition involving thrombosis (clot formation) in the dural venous sinuses that drain blood from the brain.
</aside>
https://www.youtube.com/watch?v=E7d4Jt28BW8
https://www.youtube.com/watch?v=8ZlrQehYZlU&t=299s
Dural venous system:
Diagram showing the main components of the cerebral venous system. Blue vessels represent the deep venous system.
Flowchart showing the intracranial venous system
Mahal, S., Yadav, T., Panda, S. et al. Multimodality imaging in cerebral venous thrombosis: a synopsis for emergency radiologist. Jpn J Radiol 42, 437–449 (2024). https://doi.org/10.1007/s11604-023-01522-y
Cerebral venous sinus anatomy: A Sagittal and B coronal oblique phase-contrast MR Venogram with color overlay showing the anatomy of the cerebral venous sinuses along with percentage distribution of cerebral venous thrombosis. The superior sagittal sinus (63%) remains the most common location for thrombosis, followed by the transverse sinus (57%) and sigmoid sinus (15%). Deep venous system thrombosis accounts for a total of ~ 32% of the cases
Mahal, S., Yadav, T., Panda, S. et al. Multimodality imaging in cerebral venous thrombosis: a synopsis for emergency radiologist. Jpn J Radiol 42, 437–449 (2024). https://doi.org/10.1007/s11604-023-01522-y
Axial T1 MPRAGE images with color overlay showing the venous drainage territory of the brain. PCF: Posterior cerebral fossa
Mahal, S., Yadav, T., Panda, S. et al. Multimodality imaging in cerebral venous thrombosis: a synopsis for emergency radiologist. Jpn J Radiol 42, 437–449 (2024). https://doi.org/10.1007/s11604-023-01522-y
https://doi.org/10.3390/jcm13164730
| Category | Examples |
|---|---|
| Prothrombotic states | Inherited thrombophilia (Factor V Leiden, protein C/S deficiency), antiphospholipid syndrome |
| Hormonal | Oral contraceptive pills, pregnancy, puerperium |
| Infections | Otitis media, mastoiditis, sinusitis, meningitis |
| Inflammatory disorders | Lupus, vasculitis, inflammatory bowel disease |
| Neoplastic | Brain tumors compressing sinuses |
| Trauma/surgery | Neurosurgical procedures, head injury |
| Others | Dehydration (esp. in children), COVID-19-related coagulopathy, heparin-induced thrombocytopenia (VITT) |
Traumatic CSVT: https://doi.org/10.1016/j.wneu.2024.05.019
Distinctions between spontaneous and traumatic cerebral venous sinus thrombosis (CVST). Typical spontaneous CVST occurs in the setting of a hypercoagulable state with concern for thrombus propagation and resultant symptomatic venous infarction mitigated by anticoagulation. It is likely that traumatic CVST occurs in the setting of a penetrating intimal injury where a “beneficial” response to avoid extra-axial hemorrhage entails the formation of a clot at the site of injury. In most patients, with a normal coagulation cascade, the cycle of clot formation and breakdown is likely balanced and as such, the body naturally mitigates clot propagation while the clot beneficially “seals” the hole.
Ma L, Nail TJ, Hoz SS, et al. Traumatic Cerebral Venous Sinus Thrombosis: Management and Outcomes. World Neurosurgery. 2024;187:e949-e962. doi:https://doi.org/10.1016/j.wneu.2024.05.019