Clinical meaning
CVST occurs when thrombus forms in the dural venous sinuses, obstructing cerebral venous drainage. Increased venous pressure causes vasogenic edema, reduced CSF absorption (raised intracranial pressure), and venous infarction with hemorrhagic transformation. The thrombotic process is often related to hypercoagulable states or local infection.
Diagnosis & workup
Diagnostics & workup: - Order CT venography or MR venography (diagnostic gold standard) - Order non-contrast CT head (may show dense triangle sign) - Order D-dimer (elevated, but not specific) - Order thrombophilia workup after acute treatment - Order LP if needed (elevated opening pressure) - Order CBC and coagulation studies
Risk factors: - Oral contraceptive use - Pregnancy and postpartum period - Thrombophilia (Factor V Leiden, prothrombin mutation) - Head/neck infection (mastoiditis, sinusitis) - Malignancy - Dehydration - Inflammatory conditions (IBD, Behcet's) - Polycythemia vera