Diseases due to disturbances of venous circulation of the brain and their treatment

1. Big picture

Disturbances of cerebral venous circulation mainly mean cerebral venous thrombosis, including dural venous sinus thrombosis and cortical/deep cerebral vein thrombosis.

This is a high-yield exam topic because cerebral venous thrombosis can imitate many neurological diseases:

• Migraine-like headache

• Meningitis

• Intracerebral hemorrhage

• Ischemic stroke

• Brain tumor

• Epilepsy

• Pseudotumor cerebri / intracranial hypertension

The key exam sentence:

Cerebral venous sinus thrombosis should be suspected in a young woman with headache, seizures, focal neurological signs, raised intracranial pressure, postpartum state, oral contraceptive use, infection, or hypercoagulability.

The most important treatment principle:

Give anticoagulation with heparin even if there is hemorrhagic venous infarction, unless there is a specific contraindication.

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