Senior Neurologist, Department of Neurology, Wockhardt Hospitals, Mumbai, Maharashtra, India, Corresponding Author.
Neuroradiologist, Department of Neuroradiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
J Assoc Physicians India. 2024 Oct;72(10):38-44. doi: 10.59556/japi.72.0610.
Deep cerebral venous thrombosis (DCVT) is an uncommon cause of stroke with diverse predisposing factors, clinical presentations, imaging findings, and functional outcomes, which makes the diagnosis of DCVT even more challenging.
Retrospective observational study (December 2018 to January 2023). Cases with imaging data suggestive of DCVT were included. The neuroradiological assessment was performed using multimodality imaging to determine the location of parenchymal changes and the number of deep veins involved in isolation or with the superficial dural venous system. Clinical variables were tabulated.
Of the 206 cases with CVT in the study period, 27 had DCVT (13.1%), of which four (14.8%) had isolated DCVT (male-to-female ratio 13:14; mean age = 33.4 years). Hyperhomocysteinemia ( = 11) is the most common risk factor associated with it. The most common presentations were headaches ( = 27) and focal motor deficits ( = 13). Raised intracranial tension (ICT) was present in almost half of the study population ( = 14). Mean and median modified Rankins score (mRS) at the time of discharge were 2.0 and 1, respectively. The most common deep vein involved was the straight sinus (SS) ( = 25), followed by the internal cerebral vein ( = 23). The mean and median mRS after 3 months from discharge were 0.3 and 0, respectively.
A knowledge of diverse clinical presentations in DCVT, its neurovascular anatomy, and imaging characteristics with prompt diagnosis and timely interventions can assist in attenuating the risk of acute complications and long-term sequelae. Extensive deep grey matter involvement in DCVT is associated with neurological manifestations like altered sensorium and motor deficits, with increased severity of illness as measured by the mRS score.
深脑静脉血栓（DCVT）是一种少见的卒中病因，具有多种易患因素、临床表现、影像学表现和功能结局，这使得 DCVT 的诊断更加具有挑战性。
回顾性观察性研究（2018 年 12 月至 2023 年 1 月）。纳入有影像学资料提示 DCVT 的病例。使用多模态影像学进行神经影像学评估，以确定实质改变的部位和孤立或与硬脑膜浅静脉系统一起受累的深部静脉数量。列出临床变量。
在研究期间，206 例 CVT 中有 27 例为 DCVT（13.1%），其中 4 例（14.8%）为孤立性 DCVT（男：女=13：14；平均年龄=33.4 岁）。高同型半胱氨酸血症（=11）是最常见的与之相关的危险因素。最常见的表现是头痛（=27）和局灶性运动缺陷（=13）。几乎一半的研究人群存在颅内压升高（=14）。出院时平均和中位数改良 Rankin 评分（mRS）分别为 2.0 和 1。最常受累的深部静脉是直窦（SS）（=25），其次是大脑内静脉（=23）。出院后 3 个月的平均和中位数 mRS 分别为 0.3 和 0。
了解 DCVT 的多种临床表现、其神经血管解剖结构和影像学特征，并及时做出诊断和干预，可以降低急性并发症和长期后遗症的风险。DCVT 广泛累及深部灰质与意识改变和运动缺陷等神经表现相关，mRS 评分衡量的疾病严重程度增加。
