[Clinical and therapeutic heterogeneity of cerebral venous thrombosis: a description of a series of 20 cases].

INTRODUCTION

Current neuro-radiological techniques have led to a more frequent diagnosis of cerebral vein thrombosis (CVT), and revealed its greater clinical heterogeneity.

AIM

To analize the characteristics of the cases with the diagnosis of CVT in our unit between 1996 and 2008.

PATIENTS AND METHODS

We describe 20 cases of CVT (14 women and 6 men), with ages of 22 to 75 years.

RESULTS

Headache was the most frequent symptom, followed by intracranial hypertension, disorders of consciousness and focal deficits. Unusual presentations included transitory ischemia and progressive optical neuropathy. Subacute and chronic courses were more frequent than acute. The etiology was diverse including puerperium, contraception, hyperthyroidism, meningitis, Leiden V factor mutation, multiple myeloma, Crohn, ulcerative colitis, meningioma and epidural anesthesia. No cause was found in 8 cases. Magnetic resonance imaging was always diagnostic. Patients were anticoagulated during the acute phase. In subacute or chronic presentations, a more conservative treatment was considered on individual basis. Only 6 patients had mild sequelae.

CONCLUSIONS

We report a great variety of etiologies and patterns of presentation of CVT. CVT should be suspected in patients with subacute headache, even in outpatients. Nonacute presentation with isolated headache or intracranial hypertension could have better prognosis, requiring a less aggressive therapy.