Magnetic Resonance Venography Proving its Utility and Standard over Clinical Findings in Diagnosing Cases of Cerebral Venous Thrombosis - A Case Series

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Authors

  • Clinical Associate, MVPS Vasantrao Pawar Medical College, Nashik, Maharastra, India ,IN
  • Associate Professor, MVPS Vasantrao Pawar Medical College, Nashik, Maharastra, India ,IN

Keywords:

Cerebral Venous Thrombosis, Digital Subtraction Angiography, Diffusion Weighted Imaging, Hemorrhagic Infarcts, Intra-Cerebral Venous Sinuses, Time of Flight (TOF), Venography
Hemostasis and Thrombosis

Abstract

Introduction: Cerebral venous thrombosis is an uncommon disorder commonly seen in young, earlier this incidence was likely underestimated before the introduction of much accurate & non-invasive imaging modality. Now it has estimated that five to eight cases may be seen per year at a single tertiary-care center. Accurate and prompt diagnosis of cerebral venous thrombosis is crucial; because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term sequelae. Since the possible causes and clinical manifestations of thrombosis are multiple and varied, imaging plays a primary role in the diagnosis. A wide range of cross-sectional imaging methods and venographic techniques can be used to detect abnormalities in the brain parenchyma as well as the cerebral veins and venous sinuses. Materials and Methods: In this study so far 50 patients have been prospectively taken with suspicion of intracranial vascular lesions & were referred to radiology department for MRI Brain with venography irrespective of age and sex. The study has been conducted taking up 50 patients as per the eligibility criteria with written informed consent. Siemens Magnetom Essenza 1.5 Tesla machine was used for the study. Multi-sequential study in coronal, sagittal and axial sections was taken. Results: This study provides a survey of common clinical findings in suspected cases of cerebral venous thrombosis and in several other disorders that may include a venous thrombotic process as a component. The normal venous anatomy has also been reviewed and potential pitfalls related to image interpretation are described. Conclusion: Finally it was concluded from this study, that majority of the patients diagnosed on MR imaging; were seen to be affected with intra-cerebral veins thrombosis. This study proves MR Venography as standard modality in establishing the early diagnosis of CVT in correlation with non-specific clinical findings.

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2017-05-22

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Case Series

 

References

Heiserman JE, Dean BL, Hodak JA, Flom RA, Bird CR, Drayer BP, et al. Neurologic complications of cerebral angiography.AJNR Am J Neuroradiol. 1994; 15:1401–7.PMid:7985557.

Agid R, Shelef I, Scott JN, Farb RI. Imaging of the intracranial venous system. Neurologist 2008; 14:12–22. PMid:18195652.https://doi.org/10.1097/NRL.0b013e318157f791

Bousser MG Chiras J, Berics J, Castagine P. Cerebral venous thrombosis- A review of 38 cases. Stroke. 1985; 16(2):199–213. PMid:3975957. https://doi.org/10.1161/01.STR.16.2.199

Ein Haupl KM, Villringer A, Meister W, Mehracin S, Garner C, Pellkofer M, Haber RL, Pfister HW, Schmiedek P. Heparin treatment in sinus venous thrombosis. Lancet. 1993; 38:597–600.

Bansal BC, Gupta RR, Prakash C. Stroke during pregnancy and puerperium in young females below the age of 40 years as a result of cerebral venous /venous sinus thrombosis. Jpn Heart. 1980; 21:171–83. https://doi.org/10.1536/ihj.21.171

Nagaraja D, Taly AB, Puerperal venous sinus thrombosis in India. Sinha KK ed. Progress in clinical neurosciences. Ranchi: NSI Publications; 1989. p. 165–77. PMCid:PMC184059

Khealani BA, Wasay M, Saadah M, Sultana E, Mustafa S, Khan FS, et al. Cerebral venous thrombosis: A descriptive multicenter study of patients in Pakistan and Middle East.Stroke. 2008 Oct; 39(10):2707–11. PMid:18635853. https:// doi.org/10.1161/STROKEAHA.107.512814

Duddalwar VA. Multislice CT angiography: A practical guide to CT angiography in vascular imaging and intervention.BJR. 2004; 77:27–38. PMid:15546840. https://doi.org/10.1259/bjr/25652856

Ferro JM, Lopes MG, Rosas MJ, Ferro MA, Fontes J. Cerebral venous thrombosis portugese collaborative study group. Long-term prognosis of cerebral vein and dural sinus thrombosis. Results of the VENOPORT study. Cerebrovasc Dis. 2002; 13(4):272–8. PMid:12011553. https://doi.org/10.1159/000057855

Schievink WI, Maya MM. Cerebral venous thrombosis in spontaneous intracranial hypotension. Headache. 2008; 48:1511–9. PMid:19076649. https://doi.org/10.1111/j.15264610.2008.01251.x

Ameri A, bousser MG. Cerebral venous thrombosis. Neurolclin.1992; 10:87–111. PMid:1557011.

Bergui M, Bradac G. Clinical picture of patients with cerebral venous thrombosis and patterns of dural sinus involvement.Cerebrovasc Dis. 2003; 16:211–6. PMid:12865607.https://doi.org/10.1159/000071118

Macchi PJ, Grossman JM, Goldberg HI, Zimmerman LT, Bilaniuk LT. High field MR imaging of cerebral venous thrombosis. J Comput Assist Tomogr. 1986; 10:10– 5. PMid:3944291.https://doi.org/10.1097/00004728198601000-00002

Simonds GR, Truwit CL. Anatomy of the cerebral vasculature.Neuroimaging Clin Nam. 1994; 4:691–706.PMid:7858916.

Villablanca JP, Rodriguez FJ, Stockman T, Dahliwal S, Omura M, Hazany S, et al. MDCT angiography for detection and quantification of small intracranial arteries: Comparison with conventional catheter angiography. AJR Am J Roentgenol.2007; 188(2):593–602. PMid:17242273. https://doi.org/10.2214/AJR.05.2143