Intracranial venous thrombosis refers to occlusion of venous vessels in the cranial cavity.

Overview

• can cause cerebral infarction, much lesson common than arterial causes
• 50% of patients have isolated sagittal sinus thromboses - the remainder have coexistent lateral sinus thromboses and cavernous sinus thromboses

Epidemiology:

Intracranial venous thrombosis has an incidence of approximately 3-4 cases per million people per year. Representing 0.5%-3% of all the types of stroke, affecting predominantly younger people. Women are affected more than men and mostly between the ages of 20 and 35. This is hypothesised to be due to pregnancy and the use of the COCP.

PC

• headache (may be sudden onset)
• nausea & vomiting
• reduced consciousness
• signs include seizures, reduced consciousness, focal neurological deficits, cranial nerve palsies, and papilloedema.

Investigation

• MRI venography is the gold standard
  • CT venography is an alternative
• non-contrast CT head is normal in around 70% of patients
• D-dimer levels may be elevated

Management