Management of cerebral venous sinus thrombosis

David Goldemund M.D.
Updated on 21/03/2024, published on 13/03/2024

cerebral venous sinus thrombosis (CVST) is a potentially life-threatening condition that demands prompt diagnosis and appropriate management to reduce associated morbidity and mortality
if CVST is suspected, imaging modalities such as MR imaging and MR or CT venography can help confirm the diagnosis → Diagnosis of CVST
- CT is widely available and is the most commonly used baseline imaging modality, although MRI with venous TOF sequence is preferred for its better sensitivity
- CT is widely used as a baseline imaging modality, but MRI with venous TOF sequence is preferred due to its better sensitivity
once the diagnosis is established, general therapy and acute anticoagulation should be initiated
- the objectives of anticoagulation therapy in CVST are to:
  - prevent thrombus growth
  - facilitate spontaneous fibrinolytic activity
  - prevent recurrent VTE events
- general therapy focuses on the management of complications (seizure, venous infarction, etc.) and symptoms (headache, vomitus, etc.)
detect and treat the cause of thrombosis, if possible
endovascular treatment or surgery should be reserved for extensive or progressive thrombosis