Next Article in Journal
Refixation of a Large Osteochondral Fragment with Magnesium Compression Screws—A Case Report
Previous Article in Journal
Prebiotic Synthesis of Aspartate Using Life’s Metabolism as a Guide
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Systematic Review

Rare Causes of Cerebral Venus Sinus Thrombosis: A Systematic Review

by
Rafaella Theologou
1,†,
Antonios Nteveros
1,†,
Artemios Artemiadis
1,2 and
Konstantinos Faropoulos
3,*
1
Department of Neurology, Nicosia General Hospital, 2029 Nicosia, Cyprus
2
Medical School, University of Cyprus, 1678 Nicosia, Cyprus
3
Department of Neurosurgery, Nicosia General Hospital, 2029 Nicosia, Cyprus
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Life 2023, 13(5), 1178; https://doi.org/10.3390/life13051178
Submission received: 13 March 2023 / Revised: 15 April 2023 / Accepted: 11 May 2023 / Published: 12 May 2023

Abstract

:
Background: Cerebral venous sinus thrombosis (CVST) is a rare manifestation of thrombosis commonly caused by thrombophilia, hormonal-related factors, non-cerebral malignancy, and hematologic diseases. The aim of this review was to identify and summarize rare CVST cases. Methods: A literature search of the Medline database was performed in November 2022. CVST cases of a common cause were excluded. Demographic and clinical data were extracted. Eligible cases were categorized into inflammatory, primary CNS tumors, post-operative/traumatic, and idiopathic groups to allow statistical group comparisons. Results: 76 cases were analyzed. Idiopathic CVST was most frequently reported followed by inflammatory, post-traumatic/operative and primary CNS tumor causes. The intracranial hemorrhage rate was 23.7% and it was found to increase in the inflammatory group (45.8%). Anticoagulation was used in the majority of cases and it was significantly related to better outcomes. A low rate of anticoagulation use (43.8%) was found among CVST cases in the post-operative/traumatic group. The overall mortality rate was 9.8%. 82.4% of patients showed significant early improvement. Conclusions: Most rare CVST cases were either of idiopathic or inflammatory origin. Interestingly, hemorrhage occurred often he idiopathic CVST cases. A low rate of anticoagulation use in neurosurgical CVST cases after trauma or head surgery was observed.

1. Introduction

Cerebral venous sinus thrombosis (CVST) is a rare manifestation of thrombosis involving brain dural venous sinuses and/or cerebral veins, mainly affecting young females [1]. The incidence of CVST varies among studies and between different ethnic groups. In adults, the annual incidence of CVST is 2–5 cases per million, albeit the number of cases is increased in developing countries most likely due to the high incidence of infectious diseases [1].
In the clinical settings, CVST patients present with symptoms of headache (88.8%), seizures (39.3%), paresis (37.2%), papilledema (28.3%), and mental status changes (22%) [2]. The unspecific nature of these symptoms, especially when the headache is the sole manifestation, renders diagnosis cumbersome and delays appropriate treatment for a median of 7 days [2]. The superior sagittal and transverse sinuses are most frequently found affected, followed by the internal jugular and cortical veins, while in over 60% of CVST cases more than one sinus is found thrombosed during vascular imaging [1]. Enhanced CT scan is the mainstay of CVST diagnosis with a sensitivity of 99% [3]. However, the increasing accessibility to MRI imaging has substituted CT scans for the diagnosis.
Therapeutic doses of low molecular weight heparin (LMWH) are the mainstay of CVST treatment even in the presence of CVST-related intracranial hemorrhage [4]. Thrombolysis and endovascular treatment have also been tested in small or case series studies, but they have shown ambiguous effects and have raised many safety concerns, especially for intracranial hemorrhage [5,6]. With regards to prognosis, about 5% of CVST cases die from complications mostly related to comorbidities and CVST-related intracranial hemorrhage or [2]. However, more than 90% of the survivors achieve relative independence in a median of 16 months after the event [2].
Inherited thrombophilia, hormonal-related factors (e.g., oral contraceptives, pregnancy, puerperium), non-cerebral malignancy, head and neck infections, and systemic and hematologic diseases have been recognized as common risk factors for CVST [1]. In 85% of cases, at least one risk factor is identified, otherwise, the CVST is considered idiopathic [7]. Oral contraceptive use is by far the most common risk factor, reported in more than 80% of women in various series and associated with a pooled estimate of approximately 6-fold increased risk of CVST [8]. Pregnancy or the puerperium is responsible for 5–20% of CVST, with an incidence of 12 cases per 100,000 deliveries [9,10]. Among inherited thrombophilia abnormalities related to CVST, the most prevalent are heterozygous FV Leiden and prothrombin G20210A polymorphisms [11]. Malignanca y, mainly non-cerebral solid tumor or hematological cancer, is also a risk factor in 7% of patients with CVST [12]. Autoimmune diseases, viral infections, primary central nervous system (CNS) tumors and neurosurgical procedures are very rare risk factofor of CVST [1,13,14,15,16].
To our knowledge and clinical experience, the rare causes or risk factors of CVST are often overlooked by clinicians. Also, the literature on the rare causes is scarce or parsimonious, especially regarding reviews or meta-analyses. In this systematic review, we aimed to focus on CVST cases of rare or idiopathic etiology only. To this aim, cases were grouped into four categories; inflammatory, primary central nervous system (CNS) tumor, post-operative or post-traumatic and idiopathic. The categories of the causes of CVST were formed based on the presumed etiopathogenesis. For example, the inflammatory category included rare diseases such as viral infections or autoimmune diseases (e.g., Behcet’s disease, ulcerative colitis or other systemic autoimmune diseases) that most likely induce thrombosis through the activation of the immune response. On the other hand, CNS tumors most likely cause CVST through mechanical pressure or cell infiltration in cerebral veins. The same mechanic phenomena may also explain CVST related to previous head operations or trauma. By grouping these rare cases of CVST further analysis was facilitated. As such, in this review a descriptive analysis along with group comparisons was presented further elucidating the matter of rare causes of CVST.

2. Materials and Methods

A literature search was performed on 11 November 2022 in the Medline database to identify cases of CVST. The search terms were “cerebral venous sinus thrombosis [Title/Abstract]” NOT “COVID-19 [Title/Abstract]”. Filters were applied: case reports, English, adult: 19+ years, humans. Publications describing CVST cases with common risk factors i.e., acquired (such as antiphospholipid syndrome) or inherited thrombophilia, hormonal-related factors (e.g., oral contraceptives, pregnancy, puerperium), localized or bacterial infections, hematologic diseases and systemic malignancies were excluded. Cases of CVST caused by drugs due to isolated reporting or unknown or doubtful mechanisms of drug-related CVST. Also CVST cases due to intracranial hypotension, mainly after lumbar puncture, were also excluded due to the well-known, albeit rare, complication of lumbar puncture Also, cases that were not retrieved as full texts were excluded. Case reports failing to report adequate work-up (i.e., thrombophilia, hormonal-related factors, and autoimmunity or infection screening tests) for CVST were also excluded. The remaining cases were grouped into the following categories: active inflammatory (autoimmune or viral infections), primary CNS tumors, post-operative/post-traumatic, and idiopathic after a consensus meeting of the authors.
Extracted data included the following: gender, age (in years), location of thrombosis, the occurrence of ischemic infarct (yes/no) or intracranial hemorrhage (yes/no), CVST-related risk factor, use of anticoagulation (yes/no), other CVST-related treatment (i.e., thrombolysis, endovascular treatment), early (i.e., hospitalization period) and follow-up outcome (severely disabled/stable/improved/death/normal i.e., no neurological symptoms or signs).
The demographic and clinical characteristics of the included cases were summarized by using descriptive statistics. Group comparisons were performed by using simple univariate non-parametric tests i.e., Mann–Whitney test, Kruskal–Wallis H test and Fisher’s exact test. The level of significance was set at 0.05. The analysis was performed with IBM SPSS Statistics for Windows, version 21.0. (IBM Corp, Armonk, NY, USA).

3. Results

The PRISMA flow diagram was constructed. A total of 320 registers were retrieved from MEDLINE. Five records were removed as duplicate, 13 could not be retrieved as full texts and 35 were excluded as non-original. In total, 262 records were screened. Twenty-seven were excluded. In these records, 292 cases were sought for retrieval. Among them, 216 were excluded. Forty-four cases had a common cause for CVST, mainly inherited or acquired thrombophilia. Twenty-three cases pertained to hormonal-related factors. Ten cases had a localized or bacterial infection. In 9 cases the cause of CVST was a hematologic disease, 6 cases had a systematic malignancy, 12 cases had confirmed intracranial hypotension, and in the vast majority no cause was reported. In the latter, publications failed to provide adequate information on the work-up tests. Thus, it was not evident if these CVST cases were of idiopathic origin if there was some other cause or risk factor. As such, a total of 63 publications describing 76 cases were analyzed since they met inclusion and exclusion criteria [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79]. Table 1 summarizes the included cases.
Among the 76 cases, 30 (39.5%) had an inflammatory cause of CVST, 16 (21.1%) patients suffered CVST after surgery or head trauma, 6 (7.9%) had a primary CNS tumor and 24 (31.6%) were identified as idiopathic CVST cases. Amongst the inflammatory cases, most patients had ulcerative colitis or neuro-Behcet’s disease and there were some isolated cases of autoimmune thyroiditis, idiopathic hypertrophic pachymeningitis, Sjogren’s disease, IgM nephropathy, and viral CNS infections, especially herpetic. In the neurosurgical category, half of the cases (i.e., eight) were found with CVST after head trauma and the other half had neurosurgical surgery before the thrombotic event.
In total, there were more males than females (50.2% vs. 40.8%, respectively). The mean age was 37.2 ± 15.1 years old (range: 18–77) and did not differ by gender (p = 0.876). Most cases (57/76, 75%) had thrombosis in two or more sinuses or cerebral veins. Twelve (15.8%) patients had CVST-related infarct and 18 (23.7%) suffered CVST-related intracranial hemorrhage. Gender did not significantly affect the possibility of CVST-related infarct (p = 0.34) or hemorrhage (p = 0.586), and neither was age (i.e., for infarct p = 0.874, for hemorrhage p = 0.327). Anticoagulation as acute treatment was used in 59 (78.7%) cases, while thrombolysis or endovascular treatment was performed in 12 cases (15.8%). With regards to early outcomes, 25 case reports failed to provide adequate information on the clinical status of the patients. In the remaining 51 cases, there were 5 deaths (9.8%) and 42 cases (82.4%) were significantly improved. Four patients (7.8%) showed clinical stability. The use of anticoagulation was significantly associated with more improvement than no anticoagulation (89.5% vs. 61.5%, p = 0.036). Although, all patients (100%) that received thrombolysis or endovascular treatment were found to improve compared to 78% among those patients without such therapy, the difference was not found significant (p = 0.176). With regards to long-term monitoring, the mean clinical follow-up time was 6.6 ± 6.4 months (range: 0.75–30 months) and clinical descriptions were available for only 34 cases. Most cases (16/34, 47.1%) were completely normal, 12/34 (35.3%) were clinically stable, 5/34 (14.7%) showed improvement and there was only 1 (2.9%) death after follow-up.
Table 2 summarizes the main characteristics of the included cases by category. The primary CNS tumor group was excluded from group comparisons due to its very small sample size. The age and gender did not differ between the three remaining groups (p = 0.244 and p = 0.675, respectively). CVST-related infarct occurrence was similar between the three groups (p = 0.788). However, intracranial hemorrhage was more frequent among patients with idiopathic CVST compared to those with inflammatory or post-traumatic/post-operative CVST (45.8% vs. 10% or 18.8%, respectively, p = 0.008). Anticoagulation treatment was conspicuously withheld in patients in the post-traumatic/post-operative group (only 43.8% of patients received treatment) compared to the inflammatory (82.8%) or idiopathic group (91.7%) (p = 0.001). However, this was not found to be translated into a worse early outcome (p = 0.52) compared to the other group, as 70% of neurosurgical cases were improved compared to 85.7% and 85% in the inflammatory and idiopathic groups respectively. Despite that, we must note that 30% of patients in this group died (compared to only 4.8% and 5% in the inflammatory and idiopathic groups, respectively). Finally, most cases (>50%) in all groups were normal or improved after follow-up (analyses was not performed due to the small number of cases and different follow-up time).

4. Discussion

This systematic review aimed to identify and summarize CVST cases of rare causes and to draw clinically useful conclusions by grouping these cases according to their presumed pathogenesis. Four groups were created: inflammatory, post-operative/traumatic, primary CNS tumors, and idiopathic. The main findings of this study are discussed below.
Among cases, idiopathic CVST was the most frequent followed by inflammatory, post-traumatic/operative, and primary CNS tumor. This was in accordance with previous research wherein idiopathic CVST accounts for 15% of all CVST cases [7]. However, in the present research, these differences may be misleading if we do not take into account that categories such as “inflammatory” are more inclusive than others like primary CNS tumor. In this context, this may also suggest that the “idiopathic” category most probably includes a variety of factors or thrombotic diseases, either misdiagnosed or unknown.
Most cases in the inflammatory category had ulcerative colitis or neuro-Behcet’s disease or viral infections mostly varicella zoster virus (VZV). Inflammatory bowel disease and especially ulcerative colitis is a well-known prothrombotic disease, although CVST is a rare extraintestinal complication in these patients [13]. On the other hand, CVST is reported in 10–30% of neuro-Behcet’s disease cases [14]. Viral CNS infections and especially VZV rarely cause CVST but the incidence is to our knowledge unknown. Notably, in COVID-19 infection the frequency of CVST was about 3.5%. Inflammatory vasculopathy and the generation of prothrombotic factors are assumed to be the main culprit for the thrombotic events in inflammatory diseases [13,14,15].
CVST-related intracranial hemorrhage was found to occur in 23.7% of cases which is slightly less than the expected 30–40% for all CVST cases [1]. However, intracranial hemorrhage was more frequent among patients with idiopathic CVST (45.8%) compared to those with inflammatory (10%) or post-traumatic/post-operative (18.8%) CVST. Intracranial hemorrhage in CVST is thought to be caused by the rupture of venules due to high intravenous pressure. To our opinion, the higher incidence of hemorrhage in idiopathic CVST cases may be indicative of an underlying vasculopathy like that encountered in inflammatory diseases wherein inflammation causes disruption of the blood-brain barrier, oxidative stress, and endothelial dysfunction.
As expected, anticoagulation was the first-line treatment in our CVST cases, and it was significantly associated with better early outcomes. However, among patients in the post-traumatic/post-operative group, only 43.8% of patients received anticoagulation. Also, most CVST cases with Neuro–Behcet’s disease did not receive anticoagulation since, although still debatable, immunosuppression that suppresses venous inflammation is highly recommended in these patients. This most probably reflects the hesitancy of neurosurgeons to administer anticoagulation in the face of a possible hemorrhagic complication after surgery or a head trauma. Although anticoagulation is highly recommended even in CVST cases with brain hemorrhage, we think that, in the absence of pertinent studies, the decision would be taken on an individual basis according to the neurosurgical patients’ comorbidities [4]. In our study, only 12 patients received thrombectomy or endovascular treatment thus no safe conclusions can be made.
Finally, with regard to prognosis, 9.8% of patients died which is similar to the expected rate of fatality [1,2]. Despite that, we must note that 30% of patients in the neurosurgical group died, which could be explained by the severity of these cases due to co-morbidities. Also, the rate of both early and late improvement was high, but we must note that most case reports failed to objectify the clinical status by using scales such as the modified Rankin scale or others. As such, we could not draw safe conclusions regarding prognosis and the presented analyses should not be overstated.
This study suffers from several limitations. Firstly, there is always the chance that rare CVST cases have been missed although our search strategy and the eligibility criteria were not strict. Moreover, under-reporting issues or grey literature might also hinder case inclusion. Secondly, the grouping of cases was performed according to the assumed pathogenesis to allow comparisons and conclusions. However, this strategy produced uneven and heterogenous groups thus, no safe conclusions for group or individual disease occurrence can be made. Thirdly, 112 cases were excluded from the analysis, since no clear cause or risk factor was reported or was inadequately explored. It is very likely, that these cases were true idiopathic CVST cases and thus missed by this study. Finally, comparative statistical analysis was performed in a small number of cases thus there is always the chance of type I or II error.
In a nutshell, most rare CVST cases were either of idiopathic or inflammatory origin. An interesting finding of this study was that idiopathic CVST cases were more likely to suffer intracranial hemorrhage, which may be indicative of an underlying misdiagnosed or unknown inflammatory process as discussed above. Anticoagulation remained the mainstay of rare CVST cases and was related to better outcomes. However, we found a low rate of anticoagulation use in neurosurgical CVST cases after trauma or head surgery.

Author Contributions

Investigation, Data Curation, Writing—Original Draft Preparation: R.T. and A.N. Conceptualization, Methodology, Review & Editing, Supervision: A.A. and K.F. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

No data are available.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Capecchi, M.; Abbattista, M.; Martinelli, I. Cerebral Venous Sinus Thrombosis. J. Thromb. Haemost. 2018, 16, 1918–1931. [Google Scholar] [CrossRef] [PubMed]
  2. Ferro, J.M.; Canhão, P.; Stam, J.; Bousser, M.-G.; Barinagarrementeria, F. ISCVT Investigators Prognosis of Cerebral Vein and Dural Sinus Thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004, 35, 664–670. [Google Scholar] [CrossRef] [PubMed]
  3. Linn, J.; Ertl-Wagner, B.; Seelos, K.C.; Strupp, M.; Reiser, M.; Brückmann, H.; Brüning, R. Diagnostic Value of Multidetector-Row CT Angiography in the Evaluation of Thrombosis of the Cerebral Venous Sinuses. AJNR Am. J. Neuroradiol. 2007, 28, 946–952. [Google Scholar] [PubMed]
  4. Saposnik, G.; Barinagarrementeria, F.; Brown, R.D.; Bushnell, C.D.; Cucchiara, B.; Cushman, M.; deVeber, G.; Ferro, J.M.; Tsai, F.Y. American Heart Association Stroke Council and the Council on Epidemiology and Prevention Diagnosis and Management of Cerebral Venous Thrombosis: A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke 2011, 42, 1158–1192. [Google Scholar] [CrossRef]
  5. Viegas, L.D.; Stolz, E.; Canhão, P.; Ferro, J.M. Systemic Thrombolysis for Cerebral Venous and Dural Sinus Thrombosis: A Systematic Review. Cerebrovasc. Dis. 2014, 37, 43–50. [Google Scholar] [CrossRef]
  6. Dentali, F.; Squizzato, A.; Gianni, M.; De Lodovici, M.L.; Venco, A.; Paciaroni, M.; Crowther, M.; Ageno, W. Safety of Thrombolysis in Cerebral Venous Thrombosis. A Systematic Review of the Literature. Thromb. Haemost. 2010, 104, 1055–1062. [Google Scholar] [CrossRef]
  7. Canhão, P.; Ferro, J.M.; Lindgren, A.G.; Bousser, M.-G.; Stam, J.; Barinagarrementeria, F. ISCVT Investigators Causes and Predictors of Death in Cerebral Venous Thrombosis. Stroke 2005, 36, 1720–1725. [Google Scholar] [CrossRef]
  8. Dentali, F.; Crowther, M.; Ageno, W. Thrombophilic Abnormalities, Oral Contraceptives, and Risk of Cerebral Vein Thrombosis: A Meta-Analysis. Blood 2006, 107, 2766–2773. [Google Scholar] [CrossRef]
  9. Bousser, M.-G.; Crassard, I. Cerebral Venous Thrombosis, Pregnancy and Oral Contraceptives. Thromb. Res. 2012, 130 (Suppl. 1), S19–S22. [Google Scholar] [CrossRef]
  10. Coutinho, J.M.; Ferro, J.M.; Canhão, P.; Barinagarrementeria, F.; Cantú, C.; Bousser, M.-G.; Stam, J. Cerebral Venous and Sinus Thrombosis in Women. Stroke 2009, 40, 2356–2361. [Google Scholar] [CrossRef]
  11. Lauw, M.N.; Barco, S.; Coutinho, J.M.; Middeldorp, S. Cerebral Venous Thrombosis and Thrombophilia: A Systematic Review and Meta-Analysis. Semin. Thromb. Hemost. 2013, 39, 913–927. [Google Scholar] [CrossRef] [PubMed]
  12. Dentali, F.; Poli, D.; Scoditti, U.; Di Minno, M.N.D.; De Stefano, V.; Siragusa, S.; Kostal, M.; Palareti, G.; Sartori, M.T.; Grandone, E.; et al. Long-Term Outcomes of Patients with Cerebral Vein Thrombosis: A Multicenter Study. J. Thromb. Haemost. 2012, 10, 1297–1302. [Google Scholar] [CrossRef] [PubMed]
  13. Albakr, A.I.; AlMohish, N. Cerebral Venous Sinus Thrombosis in Inflammatory Bowel Disease: A Review of Published Case Reports. Perm. J. 2021, 25, 21.031. [Google Scholar] [CrossRef] [PubMed]
  14. Zhang, B.; Lang, Y.; Zhang, W.; Cui, L.; Deng, F. Characteristics and Management of Autoimmune Disease-Associated Cerebral Venous Sinus Thrombosis. Front. Immunol. 2021, 12, 671101. [Google Scholar] [CrossRef] [PubMed]
  15. Alamlih, L.; Abdulgayoom, M.; Menik Arachchige, S.N.; Shah, M.H.; Zahid, M. Chronic Headache and Cerebral Venous Sinus Thrombosis Due to Varicella Zoster Virus Infection: A Case Report and Review of the Literature. Am. J. Case Rep. 2021, 22, e927699. [Google Scholar] [CrossRef]
  16. Ohaeri, C.; Thomas, D.R.; Salmon, J.; Cottrell, S.; Lyons, J.; Akbari, A.; Lyons, R.A.; Torabi, F.; Davies, G.G.; Williams, C. Comparative Risk of Cerebral Venous Sinus Thrombosis (CVST) Following COVID-19 Vaccination or Infection: A National Cohort Study Using Linked Electronic Health Records. Hum. Vaccines Immunother. 2022, 18, 2127572. [Google Scholar] [CrossRef]
  17. Rehman, A.; Husnain, M.G.; Mushtaq, K.; Eledrisi, M.S. Cerebral Venous Sinus Thrombosis Precipitated by Graves’ Disease. BMJ Case Rep. 2018, 2018, bcr-2017–224143. [Google Scholar] [CrossRef]
  18. Abdalla, A.O.; Alluri, D.; Hassaballa, M.; Calvo, L.; Otaki, F. A Case of Cerebral Venous Sinus Thrombosis Presenting During Relapse of Ulcerative Colitis. Am. J. Case Rep. 2019, 20, 419–422. [Google Scholar] [CrossRef]
  19. Bouchal, S.; Alami, B.; Chtaou, N.; Abkari, M.; Maaroufi, M.; Belahsen, F. Cerebral Venous Thrombosis during Relapse of Ulcerative Colitis: Case Report with Review of Literature. J. Med. Vasc. 2021, 46, 22–27. [Google Scholar] [CrossRef]
  20. Huang, K.; Xu, Q.; Ma, Y.; Zhan, R.; Shen, J.; Pan, J. Cerebral Venous Sinus Thrombosis Secondary to Idiopathic Hypertrophic Cranial Pachymeningitis: Case Report and Review of Literature. World Neurosurg. 2017, 106, 1052.e13–1052.e21. [Google Scholar] [CrossRef]
  21. Downie, E.; Diep, J.; Sungala, N.; Wong, J. IgM Nephropathy Complicated by Cerebral Venous Sinus Thrombosis: A Case Study. BMC Nephrol. 2020, 21, 390. [Google Scholar] [CrossRef] [PubMed]
  22. Ho, T.-H.; Hsu, Y.-W.; Wang, C.-W.; Lee, J.-T.; Ting, C.-H.; Yang, F.-C. Cerebral Venous Sinus Thrombosis in A Patient with Sjögren’s Syndrome with Atypical Antibodies: A Case Report. Acta Neurol. Taiwan 2016, 25, 65–69. [Google Scholar] [PubMed]
  23. Zhu, R.; Fang, C.; Wang, J.; He, X. Acute Herpes Zoster Followed by Cerebral Venous Sinus Thrombosis. Neurol. India 2020, 68, 219–221. [Google Scholar] [CrossRef] [PubMed]
  24. Jia, J.; Xi, G.; Fan, W.; Wang, G.; Li, J.; Huang, J. Cerebrovascular Intervention Therapy Worked Positively in One Patient with Severe Cerebral Venous Sinus Thrombosis Due to Hyperthyroidism: A Case Report and Review of the Literature. J. Med. Case Rep. 2022, 16, 250. [Google Scholar] [CrossRef] [PubMed]
  25. Deskur, A.; Zawada, I.; Błogowski, W.; Starzyńska, T. Cerebral Venous Sinus Thrombosis in a Young Patient with Ulcerative Colitis: A Case Report. Medicine 2019, 98, e17428. [Google Scholar] [CrossRef]
  26. Siddiqi, S.A.; Nishat, S.; Kanwar, D.; Ali, F.; Azeemuddin, M.; Wasay, M. Cerebral Venous Sinus Thrombosis: Association with Primary Varicella Zoster Virus Infection. J. Stroke Cerebrovasc. Dis. 2012, 21, 917.e1–917.e4. [Google Scholar] [CrossRef]
  27. Ferreira, B.F.D.A.; Rodriguez, E.E.C.; Prado, L.L.d.; Gonçalves, C.R.; Hirata, C.E.; Yamamoto, J.H. Frosted Branch Angiitis and Cerebral Venous Sinus Thrombosis as an Initial Onset of Neuro-Behçet’s Disease: A Case Report and Review of the Literature. J. Med. Case Rep. 2017, 11, 104. [Google Scholar] [CrossRef]
  28. Mwita, J.C.; Baliki, K.; Tema, L. Cerebral Venous Sinus Thrombosis in HIV-Infected Patients: Report of 2 Cases. Pan Afr. Med. J. 2013, 16, 4. [Google Scholar] [CrossRef]
  29. Giammello, F.; Dell’Aera, C.; Grillo, F.; Cotroneo, M.; Casella, C.; Fazio, M.C.; La Spina, P.; Francalanza, I.; Fiorenza, A.; Toscano, A.; et al. Recurrent Intracranial Hemorrhage and Cerebral Venous Sinus Thrombosis: An Atypical Case of Neuro-Behçet’s Syndrome. Clin. Neurol. Neurosurg. 2020, 191, 105680. [Google Scholar] [CrossRef]
  30. Mokkappan, S.; Basheer, A.; Iqbal, N.; Chidambaram, S. Bilateral Thalamic Bleed and Cerebral Venous Sinus Thrombosis in Japanese Encephalitis. BMJ Case Rep. 2015, 2015, bcr2014207957. [Google Scholar] [CrossRef]
  31. Pekdemir, M.; Yilmaz, S.; Ersel, M.; Sarisoy, H.T. A Rare Cause of Headache: Cerebral Venous Sinus Thrombosis Due to Hyperthyroidism. Am. J. Emerg. Med. 2008, 26, 383.e1–383.e2. [Google Scholar] [CrossRef]
  32. Vaidya, B.; Coulthard, A.; Goonetilleke, A.; Burn, D.J.; James, R.A.; Kendall-Taylor, P. Cerebral Venous Sinus Thrombosis: A Late Sequel of Invasive Fibrous Thyroiditis. Thyroid 1998, 8, 787–790. [Google Scholar] [CrossRef] [PubMed]
  33. Jha, V.K.; Padmaprakash, K.V.; Pandey, R.; Sharda, V.; Sharma, A. Cerebral Venous Sinus Thrombosis as a Warning Signal for Double Positive Crescentic Glomerulonephritis in a Young Male with Complete Renal Recovery. Saudi J. Kidney Dis. Transpl. 2018, 29, 1488–1493. [Google Scholar] [CrossRef] [PubMed]
  34. Aydin, A.E.; Gunduz, O.; Sari, I.; Saatci, A.O.; Yilmaz, E.; Akkoc, N. Papilledema Caused by Cerebral Venous Sinus Thrombosis in a Patient with Behçet Disease. J. Clin. Rheumatol. 2013, 19, 52. [Google Scholar] [CrossRef] [PubMed]
  35. Gritti, P.; Lanterna, L.A.; Chinaglia, D.; Manara, O.; Soavi, L.; Zilio, A.; Suter, F. An Unusual Case of Meningitis. Infez. Med. 2011, 19, 45–48. [Google Scholar] [PubMed]
  36. Bialasiewicz, S.; Hart, G.; Oliver, K.; Agnihotri, S.P.; Koralnik, I.J.; Viscidi, R.; Nissen, M.D.; Sloots, T.P.; Burke, M.T.; Isbel, N.M.; et al. A Difficult Decision: Atypical JC Polyomavirus Encephalopathy in a Kidney Transplant Recipient. Transplantation 2017, 101, 1461–1467. [Google Scholar] [CrossRef]
  37. Patel, S.A.; Okeagu, C.; Jones, K.; Chaudhry, A.; Berkenstock, M.K. Neuro-Behcet Disease and Ocular Inflammation: A Case Report and Literature Review. Ocul. Immunol. Inflamm. 2022, 30, 95–103. [Google Scholar] [CrossRef]
  38. Lal, A.; Dhamne, M.C.; Hui, A.C.; Ahmad, A. Herpes Simplex Virus (HSV) Encephalitis in a Young Man: An Unusual Course. BMJ Case Rep. 2018, 2018, bcr2017222499. [Google Scholar] [CrossRef]
  39. Ascaso, F.J.; Rodriguez, A.; Cristóbal, J.A. Cranial Hypertension as First Manifestation of Behçet’s Disease: A Case Report. Doc. Ophthalmol. 2002, 105, 291–299. [Google Scholar] [CrossRef]
  40. Harper, C.M.; O’Neill, B.P.; O’Duffy, J.D.; Forbes, G.S. Intracranial Hypertension in Behçet’s Disease: Demonstration of Sinus Occlusion with Use of Digital Subtraction Angiography. Mayo Clin. Proc. 1985, 60, 419–422. [Google Scholar] [CrossRef]
  41. Elhassan, A.E.E.; Ali, M.O.K.; Bougaila, A.; Abdelhady, M.; Abuzaid, H. Hyperthyroidism as a Precipitant Factor for Cerebral Venous Thrombosis: A Case Report. J. Investig. Med. High Impact Case Rep. 2020, 8, 2324709620949309. [Google Scholar] [CrossRef] [PubMed]
  42. Fu, F.-W.; Rao, J.; Zheng, Y.-Y.; Song, L.; Chen, W.; Zhou, Q.-H.; Yang, J.-G.; Ke, J.-Q.; Zheng, G.-Q. Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage Caused by Transverse Sinus Thrombosis: A Case Report and Review of Literature. Medicine 2017, 96, e7374. [Google Scholar] [CrossRef]
  43. Tian, C.; Pu, C. Dural Enhancement Detected by Magnetic Resonance Imaging Reflecting the Underlying Causes of Cerebral Venous Sinus Thrombosis. Chin. Med. J. 2012, 125, 1513–1516. [Google Scholar] [PubMed]
  44. Raper, D.M.S.; Zukas, A.M.; Schiff, D.; Asthagiri, A.R. Geographically Remote Cerebral Venous Sinus Thrombosis in Patients with Intracranial Tumors. World Neurosurg. 2017, 98, 555–562. [Google Scholar] [CrossRef]
  45. Izadi, S.; Karkos, P.D.; Krishnan, R.; Hsuan, J.; Lesser, T.H.J. Papilloedema Secondary to Venous Sinus Thrombosis Following Glomus Jugulare Tumour Surgery. J. Laryngol. Otol. 2009, 123, 1393–1395. [Google Scholar] [CrossRef] [PubMed]
  46. Chen, K.-W.; Lin, Y.-H.; Lee, C.-W. Acute Posttraumatic Cerebral Venous Sinus Thrombosis-Induced Malignant Increased Intracranial Pressure Treated with Endovascular Dural Sinus Thrombectomy and Stenting. World Neurosurg. 2019, 128, 393–397. [Google Scholar] [CrossRef] [PubMed]
  47. Miao, Z.; Zhang, Z.; Chen, J.; Wang, J.; Zhang, H.; Lei, T. Cerebral Venous Sinus Thrombosis Following Second Transsphenoidal Surgery: Report of a Rare Complication and Review of Literature. World Neurosurg. 2018, 110, 101–105. [Google Scholar] [CrossRef] [PubMed]
  48. Isan, P.; Mondot, L.; Casolla, B.; Fontaine, D.; Almairac, F. Post-Traumatic Cerebral Venous Sinus Thrombosis Associated with Epidural Hematoma: A Challenging Clinical Situation. Neurochirurgie 2022, 68, e40–e43. [Google Scholar] [CrossRef]
  49. Dobbs, T.D.; Barber, Z.E.; Squier, W.L.; Green, A.L. Cerebral Venous Sinus Thrombosis Complicating Traumatic Head Injury. J. Clin. Neurosci. 2012, 19, 1058–1059. [Google Scholar] [CrossRef]
  50. Gong, S.; Hong, W.; Wu, J.; Xu, J.; Zhao, J.; Zhang, X.; Liu, Y.; Yu, R.-G. Cerebral Venous Sinus Thrombosis Caused by Traumatic Brain Injury Complicating Thyroid Storm: A Case Report and Discussion. BMC Neurol. 2022, 22, 248. [Google Scholar] [CrossRef]
  51. Sawarkar, D.P.; Verma, S.K.; Singh, P.K.; Doddamani, R.; Kumar, A.; Sharma, B.S. Fatal Superior Sagittal Sinus and Torcular Thrombosis After Vestibular Schwannoma Surgery: Report of a Rare Complication and Review of the Literature. World Neurosurg. 2016, 96, 607.e19–607.e24. [Google Scholar] [CrossRef] [PubMed]
  52. Manzoor, N.F.; Ray, A.; Singer, J.; Nord, R.; Sunshine, J.; Megerian, C.A.; Bambakidis, N.C.; Semaan, M.T. Successful Endovascular Management of Venous Sinus Thrombosis Complicating Trans-Labyrinthine Removal of Vestibular Schwanomma. Am. J. Otolaryngol. 2016, 37, 379–382. [Google Scholar] [CrossRef] [PubMed]
  53. Harrahill, M. An Unusual Case of Cerebral Venous Sinus Thrombosis in a Trauma Patient. J. Emerg. Nurs. 2011, 37, 203–204. [Google Scholar] [CrossRef] [PubMed]
  54. Muthukumar, N. Cerebral Venous Sinus Thrombosis and Thrombophilia Presenting as Pseudo-Tumour Syndrome Following Mild Head Injury. J. Clin. Neurosci. 2004, 11, 924–927. [Google Scholar] [CrossRef]
  55. Nagarkar, R.; Kokane, G.; Wagh, A.; Roy, S. Diplopia-an Unheralded Consequence of Neck Dissection: Case Report. Oral. Maxillofac. Surg. 2018, 22, 341–343. [Google Scholar] [CrossRef]
  56. Couban, S.; Maxner, C.E. Cerebral Venous Sinus Thrombosis Presenting as Idiopathic Intracranial Hypertension. CMAJ 1991, 145, 657–659. [Google Scholar]
  57. Kozasa, Y.; Takaseya, H.; Koga, Y.; Hiraki, T.; Mishima, Y.; Niiyama, S.; Ushijima, K. A Case of Delayed Emergence from Anesthesia Caused by Postoperative Brain Edema Associated with Unexpected Cerebral Venous Sinus Thrombosis. J. Anesth. 2013, 27, 764–767. [Google Scholar] [CrossRef]
  58. Lega, B.C.; Yoshor, D. Postoperative Dural Sinus Thrombosis in a Patient in a Hypercoagulable State. Case Report. J. Neurosurg. 2006, 105, 772–774. [Google Scholar] [CrossRef]
  59. Obeid, T.; Awada, A.; Mousali, Y.; Nusair, M.; Muhayawi, S.; Memish, S. Extensive Radiculopathy: A Manifestation of Intracranial Hypertension. Eur. J. Neurol. 2000, 7, 549–553. [Google Scholar] [CrossRef]
  60. Miller, L.; Binder, W. A 38-Year-Old Woman with Cerebral Venous Sinus Thrombosis. Rhode Isl. Med. J. 2021, 104, 34–37. [Google Scholar]
  61. O’Rourke, T.L.; Slagle, W.S.; Elkins, M.; Eckermann, D.; Musick, A. Papilloedema Associated with Dural Venous Sinus Thrombosis. Clin. Exp. Optom. 2014, 97, 133–139. [Google Scholar] [CrossRef] [PubMed]
  62. Guan, J.; Song, S.; Wang, W.; Ji, X.; Meng, R. Cerebral Venous Sinus Thrombosis Due to External Compression of Internal Jugular Vein. J. Int. Med. Res. 2021, 49, 3000605211006609. [Google Scholar] [CrossRef] [PubMed]
  63. Kunle-Hassan, F.; Dattani, M.; Snead, M.; Subash, M. Bilateral Intraocular Hemorrhage Secondary to Cerebral Venous Sinus Thrombosis. Retin. Cases Brief Rep. 2018, 12, 216. [Google Scholar] [CrossRef] [PubMed]
  64. Wong, V.S.S.; Adamczyk, P.; Dahlin, B.; Richman, D.P.; Wheelock, V. Cerebral Venous Sinus Thrombosis Presenting with Auditory Hallucinations and Illusions. Cogn. Behav. Neurol. 2011, 24, 40–42. [Google Scholar] [CrossRef]
  65. Sun, J.; He, Z.; Nan, G. Cerebral Venous Sinus Thrombosis Presenting with Multifocal Intracerebral Hemorrhage and Subarachnoid Hemorrhage: A Case Report. Medicine 2018, 97, e13476. [Google Scholar] [CrossRef]
  66. Lan, R.; Ma, Y.-Z.; Shen, X.-M.; Wu, J.-T.; Gu, C.-Q.; Zhang, Y. Bilateral Corpus Callosum and Corona Radiata Infarction Due to Cerebral Venous Sinus Thrombosis Presenting as Headache and Acute Reversible Aphasia: A Rare Case Report. BMC Neurol. 2020, 20, 249. [Google Scholar] [CrossRef]
  67. Amer, R.R.; Bakhsh, E.A. Nonaneurysmal Perimesencephalic Subarachnoid Hemorrhage as an Atypical Initial Presentation of Cerebral Venous Sinus Thrombosis: A Case Report. Am. J. Case Rep. 2018, 19, 472–477. [Google Scholar] [CrossRef]
  68. Karatsu, K.; Kikuchi, R.; Kanazawa, T.; Nakamura, A.; Miyazaki, H. Sphenoparietal Sinus and Superficial Middle Cerebral Vein Thrombosis: A Case Report and Review of Literature. Neurochirurgie 2022, 68, 432–436. [Google Scholar] [CrossRef]
  69. Carangelo, B.; Lavalle, L.; Tiezzi, G.; Branco, D.; Lippa, L.; Mileo, E.; Costantino, G.; Mariottini, A.; Muscas, G.; Maturo, A. A Rare Localization of Cerebral Venous Sinus Thrombosis. Case Report. Case report. Il G. Di Chir. 2015, 36, 79–83. [Google Scholar]
  70. Zhang, H.; Song, S.; Ouyang, Z. Intraventricular Hemorrhage Caused by Intracranial Venous Sinus Thrombosis: Case Report. Medicine 2016, 95, e3907. [Google Scholar] [CrossRef]
  71. Kawai, N.; Shindou, A.; Masada, T.; Tamiya, T.; Nagao, S. Hemodynamic and Metabolic Changes in a Patient with Cerebral Venous Sinus Thrombosis: Evaluation Using O-15 Positron Emission Tomography. Clin. Nucl. Med. 2005, 30, 391–394. [Google Scholar] [CrossRef] [PubMed]
  72. De-Giorgio, F.; Peschillo, S.; Vetrugno, G.; d’Aloja, E.; Spagnolo, A.G.; Miscusi, M. Cerebral Venous Sinus Thrombosis Due to Spontaneous, Progressive, and Retrograde Jugular Vein Thrombosis Causing Sudden Death in a Young Woman. Forensic Sci. Med. Pathol. 2015, 11, 88–91. [Google Scholar] [CrossRef] [PubMed]
  73. Hassan, A.; Ahmad, B.; Ahmed, Z.; Al-Quliti, K.W. Acute Subarachnoid Hemorrhage. An Unusual Clinical Presentation of Cerebral Venous Sinus Thrombosis. Neurosciences 2015, 20, 61–64. [Google Scholar] [PubMed]
  74. Omoto, K.; Nakagawa, I.; Park, H.S.; Wada, T.; Motoyama, Y.; Kichikawa, K.; Nakase, H. Successful Emergent Endovascular Mechanical Thrombectomy for Pediatric and Young Adult Cerebral Venous Sinus Thrombosis in Coma. World Neurosurg. 2019, 122, 203–208. [Google Scholar] [CrossRef]
  75. Gariel, F.; Berge, J.; Dousset, V. Neurological Recovery after Coma Related to Diffuse Cerebral Venous Sinus Thrombosis. Interest in Thrombi-Aspiration with Penumbra System. Interv. Neuroradiol. 2015, 21, 218–221. [Google Scholar] [CrossRef]
  76. Singh, S.; Kumar, S.; Joseph, M.; Gnanamuthu, C.; Alexander, M. Cerebral Venous Sinus Thrombosis Presenting as Subdural Haematoma. Australas. Radiol. 2005, 49, 101–103. [Google Scholar] [CrossRef]
  77. Lozano-Ros, A.; Luque-Buzo, E.; García-Pastor, A.; Castro-Reyes, E.; Díaz-Otero, F.; Vázquez-Alen, P.; Fernández-Bullido, Y.; Villanueva-Osorio, J.A.; Gil-Núñez, A. Endovascular Treatment of Cerebral Venous Sinus Thrombosis (CVST): Is a Complete Recanalization Required for a Good Clinical Outcome? J. Neuroradiol. 2016, 43, 51–54. [Google Scholar] [CrossRef]
  78. Horowitz, M.; Purdy, P.; Unwin, H.; Carstens, G.; Greenlee, R.; Hise, J.; Kopitnik, T.; Batjer, H.; Rollins, N.; Samson, D. Treatment of Dural Sinus Thrombosis Using Selective Catheterization and Urokinase. Ann. Neurol. 1995, 38, 58–67. [Google Scholar] [CrossRef]
  79. Washida, K.; Kowa, H.; Tsuji, Y.; Sekiguchi, K.; Kanda, F.; Toda, T. Multiple Deep White Matter Hyperintense Lesions on Diffusion-Weighted Imaging: Early Sign of Straight Sinus Thrombosis. J. Stroke Cerebrovasc. Dis. 2016, 25, e131–e133. [Google Scholar] [CrossRef]
Table 1. Summary of case characteristics.
Table 1. Summary of case characteristics.
ReferenceAgeGenderAnatomical LocationInfarctHaemorrhageCauseAnticoagulation TreatmentThrombolysis or Endovascular TreatmentEarly OutcomeFollow-Up Outcome
[17]31malesuperior sagittal sinus, straight sinus, and both transverse sinusesYesNoGrave’s diseaseYesNoNA18 months, normal
[18]27maleleft sagittal sinusYesNoUlcerative colitisYesNoimprovedNA
[19]27femaleleft transverse, sigmoid sinusNoNoUlcerative colitisYesNoimproved6 months, normal
[19]45maleleft temporal venous, left transverse, sigmoid sinusNoNoUlcerative colitisYesNoNA6 months, normal
[20]52femalesuperior sagittal, straight, left transverse sinusNoNoIdiopathic hypertrophic pachymeningitisYesYesimproved1 year, normal
[21]23maleright transverse sinus, sagittal sinusNoNoIgM nephropathyYesNoNA1 year, normal
[22]50femaleleft transverse sinusNoNoSjögren’s syndromeYesNoNA6 months, normal
[23]75maleleft sigmoid and transverse sinusYesNoAcute herpes zosterYesNoimprovedNAs
[24]32femaleright transverse, sigmoid sinus, and straight sinus, superior sagittal sinus, left transverse sinusNoNoGrave’s diseaseYesYesimproved3 months, improved
[15]20malesagittal sinus, straight sinus, bilateral frontal parasagittal cortical veins, transverse and sigmoid sinuses, and left internal jugular vein,NoNoVaricella zoster virusYesNoimproved2 months, normal
[25]25maleright transverse sinusNoNoUlcerative colitisYesNoimproved5 months, normal
[26]20malewidespreadNoNoVaricella zoster virusYesNoNANA
[27]28femalesuperior sagittal sinus, sigmoid sinus, and internal jugular veinNoNoNeuro–Bechet’s diseaseNoNoimprovedNA
[28]44femalesagittal, right transverse, and sigmoid sinusesNoNoHIVYesNoimprovedNA
[29]22maleright sigmoid sinusYesYesNeuro-Bechet’s diseaseNoNoimprovedNA
[30]19femaleright transverse, right sigmoid, left transverse and straight sinusesNoYesJapanese encephalitisYesNoimprovedNA
[31]28maleleft sigmoid sinusNoNoHyperthyroidism, chronic thyroiditisYesNostableNA
[32]55femaleright internal jugular vein, right sigmoid, transverse, superior sagittal sinusNoNoInvasive fibrous thyroiditisYesNoimproved3 months, NA
[33]29malefrontoparietal regionNoNoANCA and anti-GBM positivityYesNostable3 months, NA
[34]37maleboth sigmoid sinusesNoNoNeuro-Bechet’s diseaseNoNoimproved9 months, NA
[35]38femaleLeft sigmoid, transverseNoNoNeuro-Bechet’s diseaseNoNodeathdeath
[36]27maleLeft transverse sinusNoNoJC PolyomavirusYesNoimproved9 months, NA
[37]26femalebilateral transverse sinus, left venous sinus thrombosisYesNoNeuro-Bechet’s diseaseYesNoNANA
[38]31malesuperior sagittal sinusNoNoHSV encephalitisYesNoimproved1 year, normal
[39]30malesuperior sagittal sinusNoNoNeuro-Bechet’s diseaseYesNoNANA
[40]18malesuperior sagittal sinus, both transverse sinusesNoNoNeuro-Bechet’s diseaseNoNoimproved1 year, normal
[40]26femaleleft sigmoid sinusNoNoNeuro-Bechet’s diseaseNANoNANA
[41]41malesuperior sagittal sinus and adjacent cortical veinsNoNoHashimoto’s thyroiditisYesNoNA2 months/stable
[42]45maleright transverse sinusNoYesAutoimmune hyperthyroidsmYesNoimproved1 year, stable
[43]41femaleright transverse sinus, sigmoid sinus, and jugular veinNoNoPachymeningitisYesNoimproved1 month, stable
[44]21femaleleft transverse, sigmoid, jugular bulbNoNoGlioblastomaYesNoNANA
[44]61maleleft transverse, sigmoid, left internal jugular veinNoNoGlioblastomaYesNoNA12 months, NA
[44]32malebilateral transverse, sigmoidNoNoPilocytic astrocytomaYesNoNANA
[44]75maleleft sigmoidNoNoAtypical meningiomaYesNoNANA
[44]60maleright transverse, sigmoid, internal jugular veinNoNoPCNSLYesNoNA9 months, death
[44]21malesuperior sagittal sinus, right frontalNoYesOligodendrogliomaYesNoNA3 months, stable
[45]44maleLeft lateral sinus, right proximal lateral sinusNo No Post glomus jugulare tumor surgeryYes NoNANA
[46]20malesigmoid sinus, jugular bulb thrombosisNoYes Post-traumaticNo Yes improved 6 months, stable
[47]43femalesagittal sinus, right transverse sinus, sigmoid sinus, right internal jugularNo No Complications after transsphenoidal surgeryYes No improved NA
[48]42maleright transverse sinusNo NoPost-traumaticNo No NA3 months, NA
[49]37femaleright sigmoid, transverse, and straight sinuses and the posterior part of the superior sagittal sinus thrombosisNoNoPost-traumaticNo No death NA
[50]29malemultible cerebral venus thrombosisYesYesPost-traumaticYes NoNANA
[51]45femalesuperior sagittal sinus, bilateral transverse, and sigmoid sinusNoYesPost-operativeNo NodeathNA
[52]21femaleright jugular vein, sigmoid, and transverse sinuses, superior sagittal sinusNo No Post-operatively after right trans-labyrinthine craniotomyYes Yes improved 6 weeks, stable
[53]NAmalesuperior sagittal sinusNo No Post-traumaticNo Noimproved NA
[54]38malesuperior sagittalNo No Post-traumaticNo NoNANA
[55]30malesigmoid and transverse sinuses suggestive of right IJV thrombosisNoNo Therapeutic ligation of the internal jugular vein during neck dissectionYes Noimproved 1 year, normal
[56]25femalesuperior sagittal sinus, right proximal transverse sinusNo No Post-traumaticNo Noimproved 5 months, normal
[57]55malesuperior sagittal and straight sinusesYes No CraniotomyNo Nodeath NA
[57]21malesuperior sagittal and straight sinusesNo No Post-traumaticNo YesNANA
[58]67malesuperior sagittal sinus, transverse sinusNoNo Post-operativeYes No NANA
[59]28femaleright lateral and the superior sagittal sinusesNoNo Post-operativeYes Noimproved 3 months, improved
[60]38femaleleft transverse-sigmoid sinus extending into the left internal jugular veinNo No IdiopathicYes No NA1 year, NA
[61]77malesuperior sagittal sinus and right transverse sinusNo No IdiopathicYes NodeathNA
[62]72maleright transverse and sigmoid sinus, left a lateral mass of the C1 vertebraNo No IdiopathicYes NoimprovedNA
[63]32maleright jugular and transverse venous sinusNo No IdiopathicYes No improved 6 months, NA
[64]45femaleright sigmoid and transverse sinusesNoNo IdiopathicYes No stable Weeks, normal
[65]57femalesagittal sinusNo Yes IdiopathicNo No stable 18 months, some disability
[66]30femalesuperior sagittal sinus, left transverse sinusYes No IdiopathicYes No improved 2,5 years, stable
[67]44femaleleft transverse sinus, internal jugular vein,No No IdiopathicYes No improved 1 month, normal
[68]47femalesphenoparietal sinus and superficial middle cerebral veinNo Yes IdiopathicNo Noimproved 6 months, some disability
[69]35maleleft cavernous sinusNo No IdiopathicYes No improved NA
[70]24malesagittal sinus, the vein of Galen, straight sinus, left transverse sinus, and left sigmoid sinusyes Yes IdiopathicYes No improved 2 Months, stable
[71]21femaleposterior part of superior sagittal sinus, left transverse sinusNo No IdiopathicYes NoNA25 Days, NA
[72]31femaletransverse sinuses, superior sagittal sinus, right internal jugular veinNo No IdiopathicYes No NANA
[73]46malesuperior sagittal, draining veins, transverse, and sigmoid sinusesYes Yes IdiopathicYes No improved 6 months, stable
[73]35malesuperior sagittal sinusYes Yes IdiopathicYes No improved 4 months, stable
[74]25malesuperior sagittal sinus, right transverse sinus, sigmoid sinus, internal jugular veinNo Yes IdiopathicYes Yesimproved 3 months, stable
[74]22femalesuperior sagittal, left transverse, left sigmoid, straight sinusesNo Yes IdiopathicYes Yesimproved 3 weeks, normal
[75]46malesuperior sagittal sinus, cortical veins, right lateral and sigmoid sinuses, transverse, internal jugular veinNo Yes IdiopathicYes Yesimproved 2 months, some disability
[76]39femalestraight sinus, left transverse-sigmoid and superior sagittal sinusNo Yes IdiopathicYes No improved 1 month, normal
[77]21femaleLeft venous sinuses, superior sagittalNo No IdiopathicYes Yesimproved 30 days, some disability
[26]54femalesuperior sagittal, straight, right transverse, sigmoid sinusesYes No IdiopathicYes Yesimproved NA
[78]26malestraight sinus, superior sagittal sinus, torcula, transverse sinus, internal cerebral veins, a vein of Galen, vein of RosenthalNo Yes IdiopathicYes Yesimproved NA
[78]32malesuperior sagittal sinusNo YesIdiopathicYes YesNANA
[79]67malestraight sinusNo No IdiopathicYes No improved NA
Table 2. Main characteristics of the included cases by risk factor categories.
Table 2. Main characteristics of the included cases by risk factor categories.
InflammatoryPrimary CNS TumorPost-Operative or TraumaticIdiopathic
N, (%)30 (39.5)6 (7.9)16 (21.1)24 (31.6)
Mean age ± SD (range)33.7 ± 12.9 (18–75)45 ± 23.3 (21–75)36 ± 13.4 (20–67)40.3 ± 16 (21–77)
Females N, (%)12 (40)1 (16.7)6 (37.5)12 (50)
CVST-related Infarct N, (%)5 (16.7)0 (0)2 (12.5)5 (20.8)
CVST-related Hemorrhage N, (%)3 (10)1 (16.7)3 (18.8)11 (45.8)
Anticoagulation N, (%)24 (82.8)6 (100)7 (43.8)22 (91.7)
Thrombolysis or Endovascular Treatment N, (%)2 (6.7)0 (0)3 (18.8)7 (29.2)
Early outcome NA
Stable n/N (%)2/21 (9.5)0/10 (0)2/20 (10)
Improved n/N (%)18/21 (85.7)7/10 (70)17/20 (85)
Death n/N (%)1/21 (4.8)3/10 (30)1/20 (5)
Late outcome
Normal n/N (%)10/14 (71.4)0/2 (0)2/5 (40)4/13 (30.8)
Stable n/N (%)3/14 (21.4)1/2 (50)2/5 (40)6/13 (36.2)
Improved n/N (%)1/14 (7.1)0/0 (0)1/5 (20)3/13 (23.1)
Death n/N (%)0/14 (0)1/2 (50)0/5 (0)0/13 (0)
CNS: Central Nervous System, CVST: Cerebral Venous Sinus Thrombosis, SD: Standard Deviation.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Theologou, R.; Nteveros, A.; Artemiadis, A.; Faropoulos, K. Rare Causes of Cerebral Venus Sinus Thrombosis: A Systematic Review. Life 2023, 13, 1178. https://doi.org/10.3390/life13051178

AMA Style

Theologou R, Nteveros A, Artemiadis A, Faropoulos K. Rare Causes of Cerebral Venus Sinus Thrombosis: A Systematic Review. Life. 2023; 13(5):1178. https://doi.org/10.3390/life13051178

Chicago/Turabian Style

Theologou, Rafaella, Antonios Nteveros, Artemios Artemiadis, and Konstantinos Faropoulos. 2023. "Rare Causes of Cerebral Venus Sinus Thrombosis: A Systematic Review" Life 13, no. 5: 1178. https://doi.org/10.3390/life13051178

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop