Cerebral Venous Thrombosis: A Challenging Neurologic Diagnosis

Emerg Med Clin North Am. 2017 Nov;35(4):869-878. doi: 10.1016/j.emc.2017.07.004. Epub 2017 Aug 24.

Abstract

Headache is a common emergency department chief complaint. Although most are benign, emergency physicians must rapidly identify and manage the uncommon, sometimes subtle, presentation of headache from a life-threatening cause. Cerebral venous thrombosis imparts significant morbidity and mortality, and can be a challenging diagnosis. It most commonly occurs in those under 50 years of age with thrombosis of the cerebral veins/sinuses. Diagnosis is frequently delayed. The disease can present with 1 or more clinical syndromes, including intracranial hypertension with headaches, focal neurologic deficits, seizures, and encephalopathy. Diagnosis requires imaging. Treatment includes stabilization, management of complications, and anticoagulation.

Keywords: Anticoagulation; Cerebral venous thrombosis; Focal neurologic deficit; Seizure; Stroke.

Publication types

  • Review

MeSH terms

  • Computed Tomography Angiography
  • Humans
  • Intracranial Thrombosis / diagnosis*
  • Magnetic Resonance Angiography
  • Neuroimaging / methods*
  • Phlebography / methods
  • Venous Thrombosis / diagnosis*