Definition
A cerebral venous thrombosis (CVT) is a blood clot in a vein of the brain. It is a rare form of stroke.
Causes
A blood clot may develop because of 1 or more of the following:
- A medical issue or treatment that makes the blood clot when it shouldn’t
- Injury in the area
- Clots that form somewhere else in the body and travel through the blood flow
The clot blocks the flow of blood. It may lead to leaking and bleeding in the brain and damage to brain tissue.
Risk Factors
CVT is more common in people who are age 50 years and older. It is also more common in women with higher levels of estrogen.
Other things that may increase the risk of CVT include:
- Blood clotting disorders, such as factor V Leiden and antiphospholipid antibodies
- Higher levels of estrogen from contraceptives, hormone replacement therapy, pregnancy, or the period after giving birth
- Cancer
- Infections of the ear, face, or neck
- Trauma
- Procedures that had access to blood or cerebral spinal fluid
- Health problem that affects the entire body, such as lupus
- Blood disorders, such as anemia
Symptoms
Symptoms may be:
- Headache
- Pain in ear or jaw
- Problems seeing, such as blurred vision
- Swelling in scalp
- Problems understanding what is said
- Dulled senses
- Seizures
Diagnosis
The doctor will ask about your symptoms and health history. A friend or family member may be asked this information for a person who is not able to do so. A physical exam will be done. The doctor may suspect problems in the brain due to symptoms. Images of the brain will be done such as:
Treatment
Treatment will help to restore normal blood flow. Care will often start in the hospital. This will allow them to check for complications. The blood clot will need to be dissolved or removed. Options are:
Medicine
Blood thinners will be given to break up the clot and keep new clots from forming. It may be given by IV, injection, or pills. How long it is taken depends on what caused the CVT.
Other medicine may be needed to treat complications.
Surgery
Surgery may be done to remove the clot in people who do not improve with medicine. A tube is passed through blood vessels to the clot. It may be removed, or medicine may be passed straight to the clot.
Complications
Other care may be needed to treat problems created by the blood clot.
Prevention
There are no guidelines to prevent a first CVT. Steps may help to decrease the risk of a second stroke in some. This may include long-term medicine or treatment during pregnancy.
RESOURCES
Centers for Disease Control and Prevention http://www.cdc.gov
National Stroke Association http://www.stroke.org
CANADIAN RESOURCES
Health Canada https://www.canada.ca/en/health-canada.html
Heart and Stroke Foundation http://www.heartandstroke.ca
References
Cerebral vein and cerebral venous sinus thrombosis. Comprehensive Stroke Center—University of Michigan Health System website. Available at: http://www.med.umich.edu/1libr/Stroke/SinusVeinThrombosis.pdf. Updated July 2016. Accessed October 4, 2019.
Cerebral venous sinus thrombosis (CVST). Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/cerebral-venous-sinus-thrombosis. Accessed October 4, 2019.
Cerebral venous thrombosis (CVT). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cerebral-venous-thrombosis-cvt-in-adults . Updated June 6, 2018. Accessed October 4, 2019.
Revision Information
- Reviewer: EBSCO Medical Review Board Daniel A. Ostrovsky, MD
- Review Date: 08/2020
- Update Date: 09/23/2020