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Cerebral venous thrombosis in two patients with spontaneous intracranial hypotension.

Garcia-Carreira MC, Vergé DC, Branera J, Zauner M, Herrero JE, Tió E, Perpinyà GR - Case Rep Neurol Med (2014)

Bottom Line: In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins.In the other case, only a right frontoparietal cortical vein was involved.However, we advocate aggressive treatment of the underlying cerebrospinal fluid leak.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí (CSIUPT), 08208 Sabadell, Spain.

ABSTRACT
Although few patients with spontaneous intracranial hypotension develop cerebral venous thrombosis, the association between these two entities seems too common to be simply a coincidental finding. We describe two cases of spontaneous intracranial hypotension associated with cerebral venous thrombosis. In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins. In the other case, only a right frontoparietal cortical vein was involved. Several mechanisms could contribute to the development of cerebral venous thrombosis in spontaneous intracranial hypotension. When spontaneous intracranial hypotension and cerebral venous thrombosis occur together, it raises difficult practical questions about the treatment of these two conditions. In most reported cases, spontaneous intracranial hypotension was treated conservatively and cerebral venous thrombosis was treated with anticoagulation. However, we advocate aggressive treatment of the underlying cerebrospinal fluid leak.

No MeSH data available.


Related in: MedlinePlus

Cerebral angiography. Venous phase image of the right internal carotid artery shows a tubular filling defect within the superficial cortical vein of Trolard (arrow) and engorgement of the surrounding venules, suggestive of thrombosis of the vein of Trolard.
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fig3: Cerebral angiography. Venous phase image of the right internal carotid artery shows a tubular filling defect within the superficial cortical vein of Trolard (arrow) and engorgement of the surrounding venules, suggestive of thrombosis of the vein of Trolard.

Mentions: Digital subtraction angiography to investigate the cause of intracerebral hemorrhage (Figure 3) found no aneurysms or arteriovenous malformations but revealed a tubular filling defect within the right frontoparietal superficial cortical vein (vein of Trolard) and signs of congestion of the other deep and superficial veins of the brain. Contrast material was slow to empty from the left transverse sinus, suggesting moderate intracranial hypertension.


Cerebral venous thrombosis in two patients with spontaneous intracranial hypotension.

Garcia-Carreira MC, Vergé DC, Branera J, Zauner M, Herrero JE, Tió E, Perpinyà GR - Case Rep Neurol Med (2014)

Cerebral angiography. Venous phase image of the right internal carotid artery shows a tubular filling defect within the superficial cortical vein of Trolard (arrow) and engorgement of the surrounding venules, suggestive of thrombosis of the vein of Trolard.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4265689&req=5

fig3: Cerebral angiography. Venous phase image of the right internal carotid artery shows a tubular filling defect within the superficial cortical vein of Trolard (arrow) and engorgement of the surrounding venules, suggestive of thrombosis of the vein of Trolard.
Mentions: Digital subtraction angiography to investigate the cause of intracerebral hemorrhage (Figure 3) found no aneurysms or arteriovenous malformations but revealed a tubular filling defect within the right frontoparietal superficial cortical vein (vein of Trolard) and signs of congestion of the other deep and superficial veins of the brain. Contrast material was slow to empty from the left transverse sinus, suggesting moderate intracranial hypertension.

Bottom Line: In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins.In the other case, only a right frontoparietal cortical vein was involved.However, we advocate aggressive treatment of the underlying cerebrospinal fluid leak.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Hospital de Sabadell, Corporació Sanitària i Universitària Parc Taulí (CSIUPT), 08208 Sabadell, Spain.

ABSTRACT
Although few patients with spontaneous intracranial hypotension develop cerebral venous thrombosis, the association between these two entities seems too common to be simply a coincidental finding. We describe two cases of spontaneous intracranial hypotension associated with cerebral venous thrombosis. In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins. In the other case, only a right frontoparietal cortical vein was involved. Several mechanisms could contribute to the development of cerebral venous thrombosis in spontaneous intracranial hypotension. When spontaneous intracranial hypotension and cerebral venous thrombosis occur together, it raises difficult practical questions about the treatment of these two conditions. In most reported cases, spontaneous intracranial hypotension was treated conservatively and cerebral venous thrombosis was treated with anticoagulation. However, we advocate aggressive treatment of the underlying cerebrospinal fluid leak.

No MeSH data available.


Related in: MedlinePlus