Difference between revisions of "Cerebral venous sinus thrombosis"
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==Planning== | ==Planning== | ||
===Choice of investigation=== | ===Choice of investigation=== | ||
In suspected '''cerebral venous sinus thrombosis (CVST)''', computed tomographic venography (CTV), magnetic resonance venography (MRV), and digital subtraction angiography (DSA) have similar accuracies in the diagnosis.<ref name=Medscape>{{cite web|url=https://emedicine.medscape.com/article/338750-overview|title=Brain Imaging in Venous Sinus Thrombosis|author=Mahesh R Patel}} Updated: Feb 25, 2018</ref> Main advantages of MRI include rapid image taking and not being contraindicated in patients with for example a pacemaker. MRV, on the other hand, has a greater sensitivity in detecting parenchymal lesions.<ref name=Medscape/> A study from India has suggested CTV as an initial investigation of suspected CVST, with MRV being the next step in patients with equivocal findings on the CTV.<ref name="pmid29322704">{{cite journal| author=Issar P, Chinna S, Issar SK| title=Evaluation of Cerebral Venous Thrombosis by CT, MRI and MR Venography. | journal=J Assoc Physicians India | year= 2017 | volume= 65 | issue= 11 | pages= 16-21 | pmid=29322704 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29322704 }} </ref> | In suspected '''cerebral venous sinus thrombosis (CVST)''', computed tomographic venography (CTV), magnetic resonance venography (MRV), and digital subtraction angiography (DSA) have similar accuracies in the diagnosis.<ref name=Medscape>{{cite web|url=https://emedicine.medscape.com/article/338750-overview|title=Brain Imaging in Venous Sinus Thrombosis|author=Mahesh R Patel}} Updated: Feb 25, 2018</ref> Main advantages of MRI include rapid image taking and not being contraindicated in patients with for example a pacemaker. MRV, on the other hand, has a greater sensitivity in detecting parenchymal lesions.<ref name=Medscape/> A study from India has suggested CTV as an initial investigation of suspected CVST, with MRV being the next step in patients with equivocal findings on the CTV.<ref name="pmid29322704">{{cite journal| author=Issar P, Chinna S, Issar SK| title=Evaluation of Cerebral Venous Thrombosis by CT, MRI and MR Venography. | journal=J Assoc Physicians India | year= 2017 | volume= 65 | issue= 11 | pages= 16-21 | pmid=29322704 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29322704 }} </ref> | ||
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| + | ==Evaluation== | ||
| + | On CTV, a CVST is seen as a contrast filling defect: | ||
| + | <gallery> | ||
| + | File:Sagital sinus thrombus.JPG|CT venogram showing a filling defect in the sagittal sinus (black arrow) | ||
| + | File:Duralvenoussinusthrombosis.png|A dural venous sinus thrombosis of the transverse sinus. Greater on the right than left. | ||
| + | </gallery> | ||
==References== | ==References== | ||
{{reflist}} | {{reflist}} | ||
Revision as of 11:51, 3 September 2018
Author:
Mikael Häggström [notes 1]
Planning
Choice of investigation
In suspected cerebral venous sinus thrombosis (CVST), computed tomographic venography (CTV), magnetic resonance venography (MRV), and digital subtraction angiography (DSA) have similar accuracies in the diagnosis.[1] Main advantages of MRI include rapid image taking and not being contraindicated in patients with for example a pacemaker. MRV, on the other hand, has a greater sensitivity in detecting parenchymal lesions.[1] A study from India has suggested CTV as an initial investigation of suspected CVST, with MRV being the next step in patients with equivocal findings on the CTV.[2]
Evaluation
On CTV, a CVST is seen as a contrast filling defect:
CT venogram showing a filling defect in the sagittal sinus (black arrow)
A dural venous sinus thrombosis of the transverse sinus. Greater on the right than left.
References
- ↑ 1.0 1.1 Mahesh R Patel. Brain Imaging in Venous Sinus Thrombosis. Updated: Feb 25, 2018
- ↑ Issar P, Chinna S, Issar SK (2017). "Evaluation of Cerebral Venous Thrombosis by CT, MRI and MR Venography. ". J Assoc Physicians India 65 (11): 16-21. PMID 29322704. Archived from the original. .
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