This document discusses cerebral venous thrombosis (CVT), including its history, major venous drainage pathways of the cranium, aetiology, neurological features, frequency of sinus involvement, and investigations. It provides details on the dural sinuses, superficial and deep cerebral veins, dural veins, scalp veins, and cervical veins that drain the brain. Common causes of CVT include oral contraceptives, pregnancy, hematological/immunological abnormalities, infections, and malignancy. Headache and focal neurological deficits are frequent symptoms, while impaired consciousness and seizures also occur. Imaging studies like CT, MRI, and angiography along with lumbar puncture are used to diagnose CVT.

1. CEREBRAL
VENOUS
THROMBOSIS

2. HISTORY
 1828, Abercrombie
 1873, Parrot
 1888, Sir William Gowers
 1915, Holmes and Sargent
 Quincke, Meningitis

3.  MAJOR
VENOUS
DRAINING PATHWAYS
OF THE CRANIUM

4. DURAL SINUSES
• Superior sagittal sinus
• Inferior sagittal sinus
• Straight sinus
• Torcular Herophili(sinus confluens)
• Transverse sinus
• Sigmoid sinus
• Occipital sinus
• Inferior petrous sinus
• Superior petrous sinus
• Cavernous

5. SUPERFICIAL
CORTICAL VEINS
• Sylvian veins
• Trolard’s veins and Labbe’s veins
• Frontal ascending/ descending cortical veins
• Occipital cortical veins
• Sphenoparietal vein

6. DEEP CEREBRAL
VEINS
• Subependymal veins
• Thalamostriate veins
• Septal veins
• Internal cerebral veins
• Basal vein( Rosenthal’s vein)
• Galen’s vein
• Anterior pontomesencephalic veins
• Precentral cerebellar vein
• Superior and inferior vermian veins

7. DURAL VEINS
• Meningeal veins
• Emissary veins(connection between
sinus and scalp)

8. SCALP VEINS
• Occipital veins
• Temporal veins

9. CERVICAL VEINS
• Jugular bulb
• Internal jugular vein
• External jugular vein

10. AETIOLOGY
 Changes in the vessel Wall
 Changes in the blood flow
 Changes in the coagulability of blood

11. AETIOLOGY(GROUP)
• Endocrinological disturbances:Oral contraceptives,
Pregnancy
• Haematological/immunological abnormalities:
Protein C, APLA Syndrome
• Connective tissue and other inflammatory
disorders:Systemic lupus erythematosus (SLE)
• Neoplastic: Cerebral metatases
• Infective: Endocarditis
• Miscellaneous:High altitud, cardiac failure

12. Neurological Features of
CVT
Signs and Symptoms
Features(%)
Recent Headaches 95
Focal Deficits 46
Paresis 40
Dysphasia 22
Visuospatial disorder 09
Homonymous hemianopia 06
Generalized seizures 37

13. Neurological Features of
CVT
Signs and Symptoms
Features(%)
Focal Seizures only 10
Pappilloedema 41
Impaired Consciousness(GCS<14) 39
Coma(GCS<5) 15
Isolated intracranial hypertension 20
Transient neurological symptoms 14
Brainstem/cerebellar signs 12
Visual impairment 10

14. Frequency of involvement
of the various sinuses in
CVT
Structure ICVST(%) Our Study(%)
Cortical Veins 17 6.33
Superior sagittal sinus 62 71.7
Straight sinus 18 ----
Tranverse Sinus 36 33.3
Sigmoid sinus ---- 15
Jugular veins 12 ----
Vein of Galen and
Internal Cerebral vein 11 ----
Cavernous sinus ---- 1.67

15. CLINICAL FEATURES
• Lateral Sinus Thrombosis
• Cavernous Sinus Thrombosis
• Superior Sagittal Sinus Thrombosis
• Thrombosis of the other dural sinuses

16. INVESTIGATIONS
• Computerized tomography
• Magnetic resonance imaging
• Angiography
• Lumbar puncture
• Aetiological diagnosis