A. 18 - Disturbance of cerebral venous circulation Flashcards
about cerebral venous circulation?
The venous sinuses are important in CSF absorption, with arachnoid villi invaginating the
sagittal sinus in particular
Thrombotic occlusion of the venous system occurs with?
● Infection (especially ear or sinus infection)
● Dehydration
● Pregnancy and puerperium
● Coagulation disorders
● Malignant meningitis
● Miscellaneous disorders (e.g. sarcoid, Behçets)
of all srokes how many % is Venous infarction?
how do you recognize it?
1%
Improved imaging (MRI)
symptoms of Superior sagittal and lateral sinus thrombosis
○ Impaired CSF drainage results in:
- headache
- papilloedema
- impaired consciousness.
○ Venous infarction produces:
- seizures
- focal deficits (e.g. hemiplegia).
diagnosis of Superior sagittal and lateral sinus thrombosis?
○ Suggested by venous (nonarterial territory) infarction
○ ‘Empty delta’ sign (following contrast the wall of the sinus enhances but not the central thrombus on CT)
○ Confirmed by occlusion of filling deficit on MR or CT venography
what is the outcome for Superior sagittal and lateral sinus thrombosis?
- variable
- intracranial hypertension may develop.
A thorough search for causation →
coagulation screen, drug history and underlying systemic illness is essential
how do you treat Superior sagittal and lateral sinus thrombosis?
- Correct causative factors (dehydration/infection etc.)
- anticoagulation with heparin or alternative.
out of all cerebral venous thrombosis, how many % is Superior sagittal and lateral sinus thrombosis?
85%
out of all cerebral venous thrombosis, how many % is Deep cerebral venous thrombosis?
10%
what does Deep cerebral venous thrombosis cause?
- venous infarction of the basal ganglion
- other subcortical structures.
how can you diagnose Deep cerebral venous thrombosis?
diagnosis can only be established by imaging (CT/MRI and MRV).
how do you treat Deep cerebral venous thrombosis?
- Correct causative factors (dehydration/infection etc.)
- anticoagulation with heparin or alternative.
out of all cerebral venous thrombosis, how many % is Cavernous sinus thrombosis?
5%
etiology of Cavernous sinus thrombosis?
Commonly results from infection spreading from the jaw through draining veins or paranasal
sinuses.
symptoms of Cavernous sinus thrombosis?
Painful ophthalmoplegia
proptosis
Chemosis with oedema of periorbital structures are associated with facial numbness and fever.
