Cerebral venous thrombosis: opportunities of advanced neuroimaging and endovascular interventional therapy (case report)
https://doi.org/10.24884/2078-5658-2025-22-5-114-120
Abstract
The objective was to present a clinical case of progressive cerebral venous thrombosis (CVT) with use of advanced neuroimaging techniques and a multidisciplinary approach in the emergency treatment strategy.
Results. A clinical case of a 48-year-old female patient with CVT was described. The diagnostic search included the use of advanced neuroimaging of brain structures. Due to the insufficient effectiveness of conservative therapy, endovascular intervention was performed – transvenous thrombectomy followed by stenting of the cerebral venous sinuses. Restoring of venous outflow led to the regression of neurological deficit. The case was discussed in the context of current diagnostic and treatment strategies for CVT.
Conclusion. CVT is a rare but important cause of stroke, especially in patients without typical risk factors. Timely application of advanced neuroimaging techniques combined with a comprehensive, multidisciplinary treatment approach can lead to favorable clinical outcomes even in severe cases.
About the Authors
S. A. Makoveev
Northern State Medical University
Russian Federation
Russian Federation
Makoveev Sergey A., Cand. of Sci. (Med.), Assistant of the Department of Anesthesiology and Intensive Care
51, Troitzky str., Arkhangelsk, 163000
V. A. Saskin
Northern State Medical University
Russian Federation
Russian Federation
Saskin Vitaliy A., Cand. of Sci. (Med.), Associate Professor of the Department of Anesthesiology and Intensive Care
51, Troitzky str., Arkhangelsk, 163000
I. N. Deryabina
Northern State Medical University
Russian Federation
Russian Federation
Deryabina Iirna, N. Assistant of the Department of Neurology
51, Troitzky str., Arkhangelsk, 163000
V. A. Khomenko
Northern State Medical University
Russian Federation
Russian Federation
Khomenko Valeria A., Student
51, Troitzky str., Arkhangelsk, 163000
M. Yu. Kirov
Northern State Medical University
Russian Federation
Russian Federation
Kirov Mikhail Yu., Dr. of Sci. (Med.), Professor, Corresponding Member of the RAS, Head of Department of Anesthesiology and Intensive Care
51, Troitzky str., Arkhangelsk, 163000
References
1. Kulesh A. A. Cerebral venous thrombosis and its hemorrhagic complications. Neurology, Neuropsychiatry, Psychosomatics, 2021, vol. 13, no. 2, pp. 10–18. (In Russ.). https://doi.org/10.14412/2074-2711-2021-2-10-18.
2. Ramazanov G. R., Korigova Kh. V., Petrikov S. S. Diagnosis and treatment of cerebral venous thrombosis. The Sklifosovsky Journal of Emergency Medical Care, 2021, vol. 10, no. 1, pp. 122–134. (In Russ.). https://doi.org/10.23934/2223-9022-2021-10-1-122-134.
3. Barboza M. A., Chiquete E., Arauz A. et al. A practical score for prediction of outcome after cerebral venous thrombosis. Front Neurol, 2018, vol. 9, article 882. https://doi.org/10.3389/fneur.2018.00882.
4. Bousser M. G., Ferro J. M. Cerebral venous thrombosis: an update. Lancet Neurol, 2007, vol. 6, no. 2, pp. 162–170. https://doi.org/10.1016/S1474-4422(07)70029
5. Buyck P. J., De Keyzer F., Vanneste D. et al. CT density measurement and H:H ratio are useful in diagnosing acute cerebral venous sinus thrombosis. AJNR Am J Neuroradiol, 2013, vol. 34, no. 8, pp. 1568–1572. https://doi.org/10.3174/ajnr.A3469.
6. Conforto A. B., Nader S. N., Puglia P. Jr. et al. Dural arteriovenous fistula and cerebral venous thrombosis. Arq Neuropsiquiatr, 2015, vol. 73, no. 6, p. 548. https://doi.org/10.1590/0004-282X20150050.
7. Coutinho J. M., Zuurbier S. M., Stam J. Declining mortality in cerebral venous thrombosis: a systematic review. Stroke, 2014, vol. 45, no. 5, pp. 1338–1341. https://doi.org/10.1161/STROKEAHA.113.004666.
8. Ferro J. M., Bousser M. G., Canhão P. et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology. Eur J Neurol, 2017, vol. 24, no. 10, pp. 1203–1213. https://doi.org/10.1111/ene.13381.
9. Ferro J. M., Coutinho J. M., Dentali F. et al. Safety and efficacy of dabigatran etexilate vs dose-adjusted warfarin in patients with cerebral venous thrombosis: a randomized clinical trial. JAMA Neurol, 2019, vol. 76, no. 12, pp. 1457–1465. https://doi.org/10.1001/jamaneurol.2019.2764.
10. Gaikwad A. B., Mudalgi B. A., Patankar K. B. et al. Diagnostic role of 64-slice multidetector row CT scan and CT venogram in cases of cerebral venous thrombosis. Emerg Radiol, 2008, vol. 15, no. 5, pp. 325–333. https://doi.org/10.1007/s10140-008-0723-4.
11. Lewis W., Saber H., Sadeghi M. et al. Transvenous endovascular recanalization for cerebral venous thrombosis: a systematic review and meta-analysis. World Neurosurg, 2019, vol. 130, pp. 341–350. https://doi.org/10.1016/j.wneu.2019.06.211.
12. Paybast S., Mohamadian R., Emami A. et al. Safety and efficacy of endovascular thrombolysis in patients with acute cerebral venous sinus thrombosis: a systematic review. Interv Neuroradiol, 2024, vol. 30, no. 5, pp. 746–758. https://doi.org/10.1177/15910199221143418.
13. Pongmoragot J., Saposnik G. Intracerebral hemorrhage from cerebral venous thrombosis. Curr Atheroscler Rep, 2012, vol. 14, no. 4, pp. 382–389. https://doi. org/10.1007/s11883-012-0260-1.
14. Sader N., de Lotbinière-Bassett M., Tso M. K., Hamilton M. Management of venous sinus thrombosis. Neurosurg Clin N Am, 2018, vol. 29, no. 4, pp. 585–594. https://doi.org/10.1016/j.nec.2018.06.011.
15. Saposnik G., Bushnell C., Coutinho J. M. et al. Diagnosis and management of cerebral venous thrombosis: a scientific statement from the American Heart Association. Stroke, 2024, vol. 55, no. 3, pp. e77–e90. https://doi.org/10.1161/STR.0000000000000456.
16. Sassi S. B., Touati N., Baccouche H. et al. Cerebral venous thrombosis: a Tunisian monocenter study on 160 patients. Clin Appl Thromb Hemost, 2017, vol. 23, no. 8, pp. 1005–1009. https://doi.org/10.1177/1076029616665168.
17. Skajaa N., Vandenbroucke J. P., Simonsen C. Z. et al. Thromboembolic events, bleeding, and mortality in patients with cerebral venous thrombosis: a nationwide cohort study. Blood Adv, 2023, vol. 7, no. 10, pp. 2070–2081. https://doi.org/10.1182/bloodadvances.2022008622.
18. Ulivi L., Squitieri M., Cohen H. et al. Cerebral venous thrombosis: a practical guide. Pract Neurol, 2020, vol. 20, no. 5, pp. 356–367. https://doi.org/10.1136/practneurol-2019-002415.
19. van Dam L. F., van Walderveen M. A. A., Kroft L. J. M. et al. Current imaging modalities for diagnosing cerebral vein thrombosis – a critical review. Thromb Res, 2020, vol. 189, pp. 132–139. https://doi.org/10.1016/j.thromres.2020.03.011.
20. Xu W., Gao L., Li T. et al. The performance of CT versus MRI in the differential diagnosis of cerebral venous thrombosis. Thromb Haemost, 2018, vol. 118, no. 6, pp. 1067–1077. https://doi.org/10.1055/s-0038-1642636.
Review
For citations:
Makoveev S.A., Saskin V.A., Deryabina I.N., Khomenko V.A., Kirov M.Yu. Cerebral venous thrombosis: opportunities of advanced neuroimaging and endovascular interventional therapy (case report). Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2025;22(5):114-120. (In Russ.) https://doi.org/10.24884/2078-5658-2025-22-5-114-120
Email this article 