Cerebral Vein Thrombosis
General Information
• The most frequently involved sinus is the superior sagittal sinus.
• Pathology may be limited to an isolated intracranial pressure increase syndrome.
• More serious changes may occur as the brain parenchyma is also affected.
• Cerebral vein thrombosis causes venous infarction in the cortex and subcortical white matter or deep hemispheric structures depending on the venous system involved in the brain parenchyma.
etiology
• It can be septic and aseptic.
• Post-partum period and oral contraceptive use are the most common causes in young women.
• It has been shown that oral contraceptives increase the risk of cerebral vein thrombosis as well as peripheral vein thrombosis in women who are carriers of the factor V Leiden mutation, which is the cause of hereditary thrombophilia.
• Systemic diseases (hematological diseases, paraneoplastic conditions due to cancer, systemic inflammatory diseases such as Behçet's disease and systemic lupus erythematosus) are the most common causes of cerebral vein thrombosis in young women, apart from the aforementioned conditions.
Clinic
• Headache, nausea, vomiting and papilloedema indicating increased intracranial pressure, focal or generalized epileptic seizures indicating involvement of the brain parenchyma in the disease process, and focal neurological deficits are the most common clinical symptoms and findings.
Diagnosis
• CT is the first diagnostic method used in emergency conditions.
• For this purpose, cranial magnetic resonance imaging (MRI) and magnetic resonance venography, which can show noninvasive and dural sinuses with higher sensitivity, are applied.
Treatment
• Treatment of cerebral vein thrombosis has three pillars as etiological, symptomatic and antithrombotic therapy.
Cavernous Sinus Syndrome
0 It is idiopathic inflammation of the sinus cavernosus.
0 3,4,5,6 nerve palsies
0 In cavernous sinus thrombosis, there may be miosis due to sympathetic denervation, as well as mydriasis due to involvement of the third nerve.
0 There is painful abducens palsy.
0 Vein superior ophthalmica is poured into the superior sinus cavernosus.
0 Since there are no valves in the facial veins, the infection can be carried to this region.
0 Because of the anastomosis between the angular vein and the ophthalmic vein, and through the angular vein, the cavernous sinus thrombus occurs.
0 There is immobility of the eye muscles and involvement of the trigeminal ophthalmic branch.