emDocs - July 6, 2016 - Authors: Long B and Koyfman A - Edited by: Robertson J
"Summary
- CVT is a rare and difficult diagnosis to make due to a wide variety of signs and symptoms.
- Patients are commonly under 50 years of age.
- Scenarios warranting CVT investigation include headache that is atypical and persistent, stroke with no typical risk factors or in the setting of seizure, intracranial hypertension with no explanation, multiple hemorrhagic infarcts, hemorrhagic infarcts not in a specific arterial distribution, or objective neurologic symptoms in a patient with risk factors for CVT.
- Patients can present with four major syndromes, the most common of which is headache from intracranial hypertension.
- Do not rely on labs such as D-dimer for ruling out or ruling in. Imaging is required, including CT with venography or MRI/MRV.
- Treatment includes stabilizing immediate condition, anticoagulation, and managing underlying condition."