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
Focal Deficits
Paresis
Dysphasia
Visuospatial disorder
Homonymous hemianopia
Generalized seizures

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

14. Frequency of involvement of the various sinuses in CVT
Structure ICVST(%) Our Study(%)
Cortical Veins
Superior sagittal sinus
Straight sinus
Tranverse Sinus
Sigmoid sinus
Jugular veins
Vein of Galen and
Internal Cerebral vein
Cavernous sinus

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