Cerebral venous thrombosis (CVT) is a rare disorder involving occlusion of the venous sinus (most commonly superior sagittal and lateral sinuses) . CVT is a very difficult diagnosis with a highly variable onset that may include visual, neurologic or even infectious like symptoms. Predisposing factors include:
- Cancer
- Pregnancy
- Local infections (otitis media, sinusitis, cellulitis)
- Hypercoagulable states
- Trauma
- Drugs (ecstasy, androgens, OCPs)
- Compression of venous sinus (tumor, abscess)
Suspect CVT in patients presenting with headache, signs of increased ICP, or focal neurologic deficits, especially if any of above predisposing factors are present. Do not use a D-dimer to rule out CVT. The workup includes, an MRI and MRV unless there is a contraindication, then CT venogram is acceptable.
