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{{Cerebral venous sinus thrombosis}}
{{Cerebral venous sinus thrombosis}}
{{CMG}} {{AE}} {{ SharmiB}}
==Overview==
[[Genetic]] or acquired conditions causing [[thrombosis]] are considered as risk factors for developing [[cerebral venous sinus thrombosis]].
==Causes==
There are more than 100 different causes of [[cerebral venous sinus thrombosis]] (CVT). Virchow's principles ([[blood]] stasis, modification of [[vascular]] wall, and [[blood]] [[rheology]]) should be used to identify all the predisposing [[conditions]] for CVT. There are also some [[genetic]] and acquired [[causes]] leading to CVT. In the [[cohort]] of an International study of [[cerebral]] [[vein]] and dural sinus [[thrombosis]](ISCVT), 34% of [[patients]] had [[thrombophilia]] while 22% of them had acquired [[thrombophilia]].<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
'''Genetic prothrombotic causes''' <ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>


There are more than 100 different causes of [[cerebral venous sinus thrombosis]] (CVT). Virchow's principles ([[blood]] stasis, modification of [[vascular]] wall, and [[blood]] [[rheology]]) should be used to identify all the predisposing [[conditions]] for CVT. There are also some [[genetic]] and acquired [[causes]] leading to CVT. In the [[cohort]] of an International study of [[cerebral]] [[vein]] and dural sinus [[thrombosis]](ISCVT), 34% of [[patients]] had [[thrombophilia]] while 22% of them had acquired [[thrombophilia]].
[[Genetic]] prothrombotic causes:
- [[Antithrombin]] [[deficiency]]
- [[Antithrombin]] [[deficiency]]


- [[Protein C]] and S [[deficiency]]
- Factor v Leiden [[mutation]]
- [[Resistance]] to activated [[protein C]]
- [[prothrombin]] [[mutation]] (A–G at position 20210)
- [[mutations]] leading to homocysteinemia
- methylenetetrahydrofolate [[reductase]] (MTHFR)
'''Acquired Prothrombotic States'''<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
- [[pregnancy]]
- [[puerperium]]
- homocysteinemia
- [[antiphospholipid antibody]]
- [[nephrotic syndrome]]
'''Infection''' <ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
- [[meningitis]]
- [[otitis]]
- [[mastoiditis]]
- [[sinusitis]]
- [[neck]], [[face]], [[mouth]] [[infection]]
- systemic [[infectious diseases]]
- [[AIDS]]
'''Inflammatory Autoimmune Diseases'''<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>


- [[Protein C]] and S [[deficiency]]
- [[systemic lupus erythematosus]]
- Adamantiades-[[Behçet disease]]
- [[Wegener granulomatosis]]
- [[sarcoidosis]]
- [[inflammatory bowel disease]]
- [[thromboangiitis obliterans]]
'''Hematology'''<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
 
- [[polycythemia]]
 
- [[thrombotic]] [[thrombocytopenic purpura]]
 
- thrombocythemia
 
- severe [[anemia]] and [[autoimmune hemolytic anemia]]
 
- [[paroxysmal nocturnal hemoglobinuria]]
 
- [[heparin-induced thrombocytopenia]]
 
'''Drugs'''<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
 
- oral contraceptives
 
- [[lithium]], [[androgens]]
 
- [[sumatriptan]]
 
- [[intravenous immunoglobulin]]
 
- [[hormone replacement therapy]]
 
- [[asparaginase]]
 
- [[steroids]]
 
- illicit [[drugs]] (such as ecstasy)
 
'''Mechanical Causes'''<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
 
- [[head trauma]]
 
- [[neurosurgical]] procedures
 
- [[jugular vein]] [[catheterization]]
 
- [[lumbar puncture]]
 
- [[injury]] to [[cerebral]] [[sinuses]]
 
- [[intravenous]] [[drug]] [[abuse]]
 
'''Malignancy'''<ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
 
- CNS [[tumors]]
- [[systemic]] [[malignancies]]
 
- [['''solid''']] '''[[tumors]]''' outside ['''[CNS''']]
 
'''Other Causes'''<ref name="Stam2005">{{cite journal|last1=Stam|first1=Jan|title=Thrombosis of the Cerebral Veins and Sinuses|journal=New England Journal of Medicine|volume=352|issue=17|year=2005|pages=1791–1798|issn=0028-4793|doi=10.1056/NEJMra042354}}</ref><ref name="FilippidisKapsalaki2009">{{cite journal|last1=Filippidis|first1=Aristotelis|last2=Kapsalaki|first2=Eftychia|last3=Patramani|first3=Gianna|last4=Fountas|first4=Kostas N.|title=Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment|journal=Neurosurgical Focus|volume=27|issue=5|year=2009|pages=E3|issn=1092-0684|doi=10.3171/2009.8.FOCUS09167}}</ref>
 
- [[dehydration]], especially in [[children]]
 
- toxicosis


- arteriovenous [[malformations]]


- Factor v Leiden [[mutation]]
- dural [[fistulae]]


- [[congenital heart disease]]


- [[Resistance]] to activated [[protein C]]
- post [[radiation]]


== References ==
==References ==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 05:14, 31 July 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S

Overview

Genetic or acquired conditions causing thrombosis are considered as risk factors for developing cerebral venous sinus thrombosis.

Causes

There are more than 100 different causes of cerebral venous sinus thrombosis (CVT). Virchow's principles (blood stasis, modification of vascular wall, and blood rheology) should be used to identify all the predisposing conditions for CVT. There are also some genetic and acquired causes leading to CVT. In the cohort of an International study of cerebral vein and dural sinus thrombosis(ISCVT), 34% of patients had thrombophilia while 22% of them had acquired thrombophilia.[1][2]


Genetic prothrombotic causes [1][2]

- Antithrombin deficiency

- Protein C and S deficiency

- Factor v Leiden mutation

- Resistance to activated protein C

- prothrombin mutation (A–G at position 20210)

- mutations leading to homocysteinemia

- methylenetetrahydrofolate reductase (MTHFR)


Acquired Prothrombotic States[1][2]

- pregnancy

- puerperium

- homocysteinemia

- antiphospholipid antibody

- nephrotic syndrome

Infection [1][2]

- meningitis

- otitis

- mastoiditis

- sinusitis

- neck, face, mouth infection

- systemic infectious diseases

- AIDS

Inflammatory Autoimmune Diseases[1][2]

- systemic lupus erythematosus

- Adamantiades-Behçet disease

- Wegener granulomatosis

- sarcoidosis

- inflammatory bowel disease

- thromboangiitis obliterans

Hematology[1][2]

- polycythemia

- thrombotic thrombocytopenic purpura

- thrombocythemia

- severe anemia and autoimmune hemolytic anemia

- paroxysmal nocturnal hemoglobinuria

- heparin-induced thrombocytopenia

Drugs[1][2]

- oral contraceptives

- lithium, androgens

- sumatriptan

- intravenous immunoglobulin

- hormone replacement therapy

- asparaginase

- steroids

- illicit drugs (such as ecstasy)

Mechanical Causes[1][2]

- head trauma

- neurosurgical procedures

- jugular vein catheterization

- lumbar puncture

- injury to cerebral sinuses

- intravenous drug abuse

Malignancy[2]

- CNS tumors

- systemic malignancies

- '''solid''' tumors outside [[CNS]]

Other Causes[1][2]

- dehydration, especially in children

- toxicosis

- arteriovenous malformations

- dural fistulae

- congenital heart disease

- post radiation

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Stam, Jan (2005). "Thrombosis of the Cerebral Veins and Sinuses". New England Journal of Medicine. 352 (17): 1791–1798. doi:10.1056/NEJMra042354. ISSN 0028-4793.
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 Filippidis, Aristotelis; Kapsalaki, Eftychia; Patramani, Gianna; Fountas, Kostas N. (2009). "Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment". Neurosurgical Focus. 27 (5): E3. doi:10.3171/2009.8.FOCUS09167. ISSN 1092-0684.
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