engleski

Clinical characteristics, diagnostic procedures and therapy of cerebral venous and sinus thrombosis – a case report.

Introduction/Objectives: Cerebral venous and sinus thrombosis (CVST) is a rare type of cerebrovascular disease which accounts for <1% of all the strokes and is characterized by widespread thrombus within the central venous sinus system. CVST can occur at any age and is more frequent in young adultst. The incidence in the adult population is 3-4 cases per 2 million per year, and in children is 0.67 cases per 100 000 children below 18 years. The predisposing factors include the use of oral contraceptives, pregnancy, childbirth, congenital and aquired coagulation disorders, neoplastic processes, cardiac defects, systemic diseases of the connective tissue etc. Risk factors cannot be identified in about 15% of cases. CVST are associated with accelerated coagulation and increased blood density, and occures following endothelial damage and slowed blood flow. Diagnosis was based on neuroimaging – computed tomography, magnetic resonance imaging, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, magnetic resonance venography. Objectives: Review of clinical characteristics, diagnostic procedures and therapy patient of cerebral venous and sinus thrombosis. Case report: 73-year-old female hospitalized after the onest of severe headache, dizziness, nausea, vomiting and the right-sided hemiparesis 4/5 degree. Hyperdense signal and empty delta sign on computed tomography image and the combination of absence of a flow void with alternation of signal intensity in the dural sinus on MRI were the suggestive signs of CVST. Except the elevated D-dimer values, other laboratory findings were within the reference range. Genetic and acquired coagulation disorders were excluded, and the laboratory and radiology processing for detection of malignancy were negative. The patient was treated with body weight-adjusted subcutaneous lowmolecular-weight heparin with a good clinical response– dissapearance of signs and symptoms and the absence of complications. After the acute phase of the disease she took oral anticoagulant therapy for 1 year. Conclusions: We reported a case of multiple segmental sinovenous thrombosis with good prognosis. Early diagnosis and application of anticoagulant therapy affect the outcome of CVST. The aims of antithrombotic therapy in CVST are to recanalise the occluded sinus or vein, to prevent the propagation of the thrombus and to prevent the recurrence of CVST.

cerebral venous and sinus thrombosis

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