[Cerebral venous thromboses].

Abstract

UNLABELLED: VARIABLE EXPRESSION: The clinical expression of cerebral venous thrombosis varies widely. The only manifestation may be an intracranial hypertension if the thrombus is limited to the superior longitudinal sinus or a predominant lateral sinus. Thrombosis of cortical veins, alone or in association with a sinus thrombus causes venous infarction. PROGNOSIS: Deep venous thrombosis generally leads to coma with signs of intracranial hypertension. However, partial or complete recovery is possible, even with a severe initial presentation, underlining the importance of early diagnosis and treatment. DIAGNOSTIC METHODS: Magnetic resonance imaging (MRI) coupled with magnetic resonance angiography (MRA) can usually confirm the diagnosis without conventional angiography. ETIOLOGICAL DIAGNOSIS: Cerebral venous thrombosis often follows prethrombotic conditions. Infectious causes only account for 10% of the cases and no cause can be identified in about 1 out of 5 cases. TREATMENT: Anticoagulation is indicated even in case of venous infarction with spontaneous bleeding. Thrombolysis can be proposed, particularly for deep venous thrombosis.