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Cerebral Venous Thrombosis

Djuliana Stoilova, Evgeniya Kalevska, Ivan Valkadinov

Abstract

Introduction: Cerebral venous thrombosis (CVT) is a rare disorder resulting from clot formation in one of the many outflow tracts of the brain. The most affected blood vessels are the superior and lateral sagittal sinuses, but all the cerebral sinuses and veins may be occluded. CVT is often seen as complication of other medical conditions; etiologic and risk factors of the disease vary and the most common include medications (especially third generation oral contraceptives), pregnancy, infections, mechanical traumas, dehydration, hematological conditions such as protein S or C deficiency, thrombocytopenia purpura, antithrombin III deficiency and others. AN important fact is that CVT is a disease affecting more patients in their twenties to forties, so it should be considered in the differential diagnosis of younger patients with relevant clinical symptoms. They are often nonspecific including headache, nausea, vomiting, diplopia, epileptic seizures, papilledema, focal deficits and other, depending on the localization of the thrombosis. A diagnosis is confirmed usually by MRI or CT and especially magnetic resonance venography of the brain.

Materials and Methods: In this case report a 37-year-old woman is admitted to the clinic for the first time with a single complaint of severe headache persisting for four days. The somatic and neurologic statuses of the patient were normal. Due to dysmenorrhea the patient was taking Yasmin by prescription from a gynecologist. 

Results: Contrast-enhanced CT of the brain showed thrombosis of the left transverse and sigmoid sinuses as well as the left internal jugular vein.

In conclusion, CVT is an important condition that should be considered not only by neurologists, but also by general practitioners, gynecologists and other specialists because of its general symptoms and serious consequences. The final clinical outcome depends on the complex interrelation between the etiology, localization, severity and evolution of the vascular process, the applied therapy and the existing co-morbidity.


Keywords

cerebral venous thrombosis, intracranial sinus thrombosis


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