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Cerebral venous thrombosis: a practical guide
  1. Leonardo Ulivi1,
  2. Martina Squitieri1,
  3. Hannah Cohen2,3,
  4. Peter Cowley1,4,
  5. David J Werring1,4
  1. 1 Stroke Research Centre, University College London Queen Square Institute of Neurology, London WC1B 5EH, UK
  2. 2 Haemostasis Research Unit, University College London, London, UK
  3. 3 Haematology, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
  4. 4 Lysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
  1. Correspondence to David J Werring, Stroke Research Centre, University College London Institute of Neurology, London, UK; d.werring{at}ucl.ac.uk

Abstract

All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). It is difficult to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations (different from ‘conventional’ stroke, and often mimicking other acute neurological conditions), and because it is often challenging to obtain and interpret optimal and timely brain imaging. Although CVT can result in death or permanent disability, it generally has a favourable prognosis if diagnosed and treated early. Neurologists involved in stroke care therefore also need to be aware of the treatments for CVT (with varying degrees of supporting evidence): the mainstay is prompt anticoagulation but patients who deteriorate despite treatment can be considered for endovascular procedures (endovascular thrombolysis or thrombectomy) or neurosurgery (decompressive craniotomy). This review summarises current knowledge on the risk factors, diagnosis, treatment and prognosis of CVT in adults, and highlights some areas for future research.

  • Amyloid
  • cerebrovascular disease
  • MRI
  • stroke
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Footnotes

  • LU and MS contributed equally

  • Contributors LU and MS prepared the first draft with DJW. HC, PC and DJW reviewed the manuscript for intellectual content. DJW and PC prepared the figures.

  • Funding DJW receives research funding support from the British Heart Foundation and the Stroke Association. This work was undertaken at University College London Hospitals NHS Foundation Trust/University College London, who received a proportion of funding from the Department of Health’s National Institute for Health Research Biomedical Research Centres funding scheme.

  • Competing interests DJW has received honoraria from Bayer, Portola and Alnylam, outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed by José Ferro, Lisbon, Portugal, and Teddy Wu, Christchurch, New Zealand.

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