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Cerebral venous sinus thrombosis: Are there any hidden causes behind fatal brain blood clots?
Cerebral venous sinus thrombosis (CVST) is a relatively rare but potentially fatal condition in which blood clots form in the veins or sinuses of the brain. According to the latest research, the incidence of this disease is about 3 to 4 cases per million people. In many cases, symptoms of CVST may include severe headaches, vision problems, and any of the symptoms of a stroke, such as loss of movement in the face or limbs. These symptoms often have a significant impact on the patient's daily life and may even lead to death.
Of particular note, approximately 40% of patients with CVST experience seizures, which are more common in women, especially during pregnancy or postpartum. This condition is usually diagnosed with computed tomography (CT) or magnetic resonance imaging (MRI) to confirm whether the sinuses are blocked. After the diagnosis is confirmed, doctors will further test for potential causes, particularly if a clear cause is unknown.
Symptoms are similar in most people with CVST, but they can vary in older people and children, complicating diagnosis.
Symptoms and Signs
According to research, about 90% of CVST patients have headaches as their initial symptom. This headache may gradually worsen over a few days, or it may appear suddenly (commonly known as thunder headache). In some cases, headache is the only symptom. In addition to headaches, many patients also experience symptoms of a stroke that don't necessarily affect just one side of the body, such as an inability to move the face normally or to speak clearly. Although rare, bilateral sixth nerve palsy may result in abnormal eye movements. Seizures occur in 40% of cases and are more common in women with antenatal or postpartum cerebral venous sinus thrombosis.
Cause Analysis
There are many causes of CVST, and in some patients these causes may be related to an underlying disorder that causes thrombosis. Approximately 85% of people with CVST have at least one known risk factor, including:
- Abnormal coagulation function: for example, factor V Leiden deficiency, protein C or protein S deficiency, etc.
- Factors related to pregnancy and postpartum period.
- Certain blood disorders, especially plethora of blood proteins and nocturnal hemoglobinuria.
- Use oral contraceptives containing estrogen.
Major illness, bedriddenness, and immune system abnormalities may increase the risk of CVST.
Diagnostic Methods
The key to diagnosing CVST is recognizing the symptoms. Doctors suspect this disorder based on a combination of headaches, signs of increased intracranial pressure, and focal neurologic abnormalities. In addition, cardiovascular examinations are essential, including brain imaging tools such as CT or MRI, which can effectively detect blood clots in the veins.
Treatment methods
Treatment of CVST usually begins with the use of anticoagulants, such as low molecular weight heparin. For most patients, this effectively prevents the blood clot from getting worse. However, if the condition is severe and accompanied by intracerebral hemorrhage, the use of anticoagulants should be considered after additional diagnosis and treatment. For some patients, surgical intervention may be necessary to reduce intracranial pressure.
Studies show that with proper treatment, patients have a high chance of recovering well, especially younger patients.
Prognosis and consequences
According to a 2004 study, approximately 57.1% of patients fully recovered at 16 months of follow-up. For most patients, blood clots disappear on their own after a few months, but the mortality rate is about 9.4%, especially in the elderly or those with other serious health problems.
Although CVST is relatively rare, awareness of its symptoms and causes is critical due to its potential lethality. Can we do more to prevent this disease from happening and raise awareness of cerebral venous sinus thrombosis?
