1. Cerebral Venous Thrombosis incidence - 1/100 000 inhabitants accounts for 0.5% to 1% of all strokes Cerebral venous infarkt – due to occlusion of cerebral veins or sinuses and consequent tissue congestion it disproportionally affects women who are pregnant or taking oral contraceptives and people 45 years and younger.

3. Cerebral Venous Thrombosis Infection etiology (70% of patients - Staphylococcus aureus, Streptococcus pneumoniae, gramnegative bacterias). Focal head infections - sinusitis, meningitis, teeth diseases, otitis, tonsilitis, furunkul, open head injury Generalized infections - endokarditis, tuberkulosis, pneumonia, hepatitis, aspergilosis, AIDS.

4. Cerebral Venous Thrombosis Non infections factors Generalized – contraception, dehydratation malignancy Systemic diseases - SLE, Wegener granulomatosis, Crohn disease Thrombophilia Pregnancy and puerperium

5. Cerebral Venous Thrombosis clinical findings Subacute onset, symptoms from the teritory in which thrombosis is present cefalea, nauzea s vomitus Hemiparesis, paraparesis, (sinus sagitalis superior) Aphasia, ataxia, chorea, hemianopsy, epileptic seazure (42- 79% of patients) Oedema of the n.II papila, cranial nerves lesions (n.VI, VII, VIII) bulbus jugularis - foramen jugulare syndrom (lesion of IX-XII nerves)

6. Cerebral Venous Thrombosis sinus cavernous (SC) trombosis Trias: conjuctival chemosis, ptosis, painful ophtalmoparesis Fewer Visual disturbances exophtalmus

7. Venous thrombosis

8. Cerebral Venous Thrombosis Sinus cavernosus Exophtamus

9. Cerebral Venous Thrombosis Sinus transversus

10. Cerebral Venous Thrombosis sinus sagitalis superior thrombosis Unilateral hemiparesis, later bilateral Central monoparesis of lower extremity or central paraparesis of lower extremities cortical vein thrombosis Rare Focal deficit – aphasia, hemiparesis, hemihypestesia, hemianopsy, etc.

11. Cerebral Venous Thrombosis Sinus sagitalis

12. Cerebral Venous Thrombosis CSF - proteino-cytologic association asociácia Proteins, erytrocytes, monocytes and polynuclears 10% - normal CSF MRI

13. Cerebral Venous Thrombosis Therapy Anticoagulants (heparin or LWMH) Later - p.o. anticoagulants (warfarin) - INR 2,0- 2,5 Usually 6 months, in coagulopathy – long time Antibiotics (3 rd generation cephalosporins) and symptomatic therapy (Manitol, antiepileptics)