18. Disturbance of cerebral venous circulation

Question 1

Explain briefly cerebral venous circulation

Answer 1

The veins of the brain are thin-walled, valveless and pierce the arachnoid mater and meningeal layer of dura mater to empty deoxygenated blood into the dural venous sinuses. The dural venous sinuses drain into the sigmoid sinus which becomes continuous with the internal jugular veins.

Question 2

What are the function of the venous sinuses?

Answer 2

To collect oxygen-depleted blood

Question 3

Etiology of cerebral venous thrombosis

Answer 3

• Hypercoaguable states (prengancy, contraceptives coag. disorders)
• Infections (esp. ear, sinus, dental)

Question 4

Diangosis of cerebral venous thrombosis

Answer 4

MRI/CT venography

Question 5

Treatment of cerebral venous thrombosis

Answer 5

Anticoagulation (LMWH) or surgical thrombolysis/decompressive craniectomy

Question 6

What is the most common cerebral sinus to have thrombosis?

Answer 6

Superior saggital sinus (85%)

Question 7

Symptoms of cerebral venous thrombosis

Answer 7

• Headache
• Increased ICP (visual imapairment, papilledema)
• Focal neurological deficits
• Seizures

Question 8

Name three locations of cerebral venous circulation

Answer 8

Superior saggital sinus, deep cerebral, cavernous sinus