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Cerebral venous thrombosis: diagnosis dilemma.

Chiewvit P, Piyapittayanan S, Poungvarin N - Neurol Int (2011)

Bottom Line: This disorder is potentially lethal but treatable, oftenly it was overlooked in both clinical and radiologic in routine practice.Whenever, clinical suspected, prompt investigation by noninvasive imaging Magnetic resonance (MR) or advanced modilities such as cerebral venous thrombosis (CVT), MRV (MR Venography) will helpful in prompt diagnosis and treatment.By using of effective treatment will improve the prognosis of the patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Division of Diagnostic Radiology.

ABSTRACT
Cerebral venous thrombosis is increasing common disease in daily practice with sharing clinical nonspecific symptoms. This disorder is potentially lethal but treatable, oftenly it was overlooked in both clinical and radiologic in routine practice. Whenever, clinical suspected, prompt investigation by noninvasive imaging Magnetic resonance (MR) or advanced modilities such as cerebral venous thrombosis (CVT), MRV (MR Venography) will helpful in prompt diagnosis and treatment. These imaging modalities may reveal either direct sign (visualization of intraluminal clot) and indirect signs (paranchymatous change, intracranial hemorrhage). By using of effective treatment will improve the prognosis of the patient. This review summarizes insights into etiology, incidence, imaging modalities and current of the treatment.

No MeSH data available.


Related in: MedlinePlus

(A) Axial computed-tomography noncontrast study) demonstrated hyperdensity of acute thrombus in left transverse sigmoid sinus (white arrow) with mixed hypo-hyperdensity lesion at left parieto-temporal region, measured about 4.9×2.8 cm in size (arrowhead). (B) Contrast enhanced computed-tomography scan shows filling defect in left transverse-sigmoid sinus (black arrow). All of these findings are suggestive of left sigmoid and transeverse sinovenous sinus thromboses with acute intracerebral hemorrhage.
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Figure 2: (A) Axial computed-tomography noncontrast study) demonstrated hyperdensity of acute thrombus in left transverse sigmoid sinus (white arrow) with mixed hypo-hyperdensity lesion at left parieto-temporal region, measured about 4.9×2.8 cm in size (arrowhead). (B) Contrast enhanced computed-tomography scan shows filling defect in left transverse-sigmoid sinus (black arrow). All of these findings are suggestive of left sigmoid and transeverse sinovenous sinus thromboses with acute intracerebral hemorrhage.

Mentions: CT is the initial modality of investigation of choice for most neurological conditions. Its widespread availability, comparatively shorter scan times and lower cost.2 It is reported that in the acute phase of CVT, almost 38% of CT scans are normal.5 Thrombus is visible on non-enhanced CT as a high-attenuation lesion in the venous channel, producing dense triangle or cord sign represents an intravascular acute blood clot.3,4 This sign is reported in 20% of patients and takes approximately 1–2 weeks to disappear. However, similarly increased attenuation of the cerebral venous sinuses may also represent polycythemia, dehydration, a subjacent subarachnoid or subdural hemorrhage and nonmyelinated brain in neonates makes sinuses appear unusually attenuating.4,8,9 Increased attenuation in the sinus (Figure 2A, Figure 3, Figure 4A,B) may be the only finding suggestive of sinus thrombosis on unenhanced CT images, and patients with this sign should be further evaluated with contrast-enhanced CT, MR imaging, or both, in the proper clinical scenario.8


Cerebral venous thrombosis: diagnosis dilemma.

Chiewvit P, Piyapittayanan S, Poungvarin N - Neurol Int (2011)

(A) Axial computed-tomography noncontrast study) demonstrated hyperdensity of acute thrombus in left transverse sigmoid sinus (white arrow) with mixed hypo-hyperdensity lesion at left parieto-temporal region, measured about 4.9×2.8 cm in size (arrowhead). (B) Contrast enhanced computed-tomography scan shows filling defect in left transverse-sigmoid sinus (black arrow). All of these findings are suggestive of left sigmoid and transeverse sinovenous sinus thromboses with acute intracerebral hemorrhage.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3286153&req=5

Figure 2: (A) Axial computed-tomography noncontrast study) demonstrated hyperdensity of acute thrombus in left transverse sigmoid sinus (white arrow) with mixed hypo-hyperdensity lesion at left parieto-temporal region, measured about 4.9×2.8 cm in size (arrowhead). (B) Contrast enhanced computed-tomography scan shows filling defect in left transverse-sigmoid sinus (black arrow). All of these findings are suggestive of left sigmoid and transeverse sinovenous sinus thromboses with acute intracerebral hemorrhage.
Mentions: CT is the initial modality of investigation of choice for most neurological conditions. Its widespread availability, comparatively shorter scan times and lower cost.2 It is reported that in the acute phase of CVT, almost 38% of CT scans are normal.5 Thrombus is visible on non-enhanced CT as a high-attenuation lesion in the venous channel, producing dense triangle or cord sign represents an intravascular acute blood clot.3,4 This sign is reported in 20% of patients and takes approximately 1–2 weeks to disappear. However, similarly increased attenuation of the cerebral venous sinuses may also represent polycythemia, dehydration, a subjacent subarachnoid or subdural hemorrhage and nonmyelinated brain in neonates makes sinuses appear unusually attenuating.4,8,9 Increased attenuation in the sinus (Figure 2A, Figure 3, Figure 4A,B) may be the only finding suggestive of sinus thrombosis on unenhanced CT images, and patients with this sign should be further evaluated with contrast-enhanced CT, MR imaging, or both, in the proper clinical scenario.8

Bottom Line: This disorder is potentially lethal but treatable, oftenly it was overlooked in both clinical and radiologic in routine practice.Whenever, clinical suspected, prompt investigation by noninvasive imaging Magnetic resonance (MR) or advanced modilities such as cerebral venous thrombosis (CVT), MRV (MR Venography) will helpful in prompt diagnosis and treatment.By using of effective treatment will improve the prognosis of the patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Division of Diagnostic Radiology.

ABSTRACT
Cerebral venous thrombosis is increasing common disease in daily practice with sharing clinical nonspecific symptoms. This disorder is potentially lethal but treatable, oftenly it was overlooked in both clinical and radiologic in routine practice. Whenever, clinical suspected, prompt investigation by noninvasive imaging Magnetic resonance (MR) or advanced modilities such as cerebral venous thrombosis (CVT), MRV (MR Venography) will helpful in prompt diagnosis and treatment. These imaging modalities may reveal either direct sign (visualization of intraluminal clot) and indirect signs (paranchymatous change, intracranial hemorrhage). By using of effective treatment will improve the prognosis of the patient. This review summarizes insights into etiology, incidence, imaging modalities and current of the treatment.

No MeSH data available.


Related in: MedlinePlus