Clinical Presentation, Imaging and Treatment of Cerebral Venous Thrombosis (CVT)

Abstract

Cerebral venous thrombosis (CVT) is a multi-causal disorder that affects the venous aspect of the neurovascular tree and is related to certain hereditary and acquired predispositions. The incidence, clinical presentation, imaging findings and clinical outcome of CVT are therefore variable and will relate to various risk factors that are predominant in different age groups1,2,3,4. CVT can also be a part of the dynamic progression of patients with intracra-nial dural arteriovenous fistulas as well as being associated with the syndrome of pseudotu-mor cerebri. No firm treatment methods for CVT have been established. However, anticoagulation, although not completely scientifically proven, is regarded as a first line treatment4,5,6,7. On the contrary, the interventional neuroradiological procedures such as transvenous thrombolysis 8,9,10 or mechanical thrombectomy11,12 are usually reserved for patients who do not show clinical response to heparin therapy. The purpose of this article is to discuss the present knowledge of the etiology, clinical presentation, diagnosis and management of this potentially devastating disease from the perspectives of the interventional neuroradiolo-gist.