Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery

Clinical and diagnostic features of cerebral venous thrombosis

A.I. Fedin 1,

N.Yu. Ermoshkina 1,

M.V. Putilina 1,

Yu.D. Vasil’ev 2,

M.B. Kozlov 2,

L.V. Sidel’nikova 2,

T.Yu. Snigereva 2

1 - Department of Neurology, Faculty of Advanced Medical Studies, N.I. Pirogov Russian National Research Medical
University, Ministry of Health of the RF;
2 - O.M. Filatov City Clinical Hospital No. 15,

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2014; (): -

Quote as: Fedin A.I., Ermoshkina N.Yu., Putilina M.V., at al. Clinical and diagnostic features of cerebral venous thrombosis. Klinicheskaya Fiziologiya Krovoobrashcheniya. 2014; 1: 32–43.

Full text:  


Objective. Work out a diagnostic algorithm for cerebral venous thrombosis.

Material and methods. 14 patients suspected with cerebral venous thrombosis were monitored during the period fr om 2006 to February 2013 in the clinic. The diagnosis was confirmed using neuroimaging methods in 9 patients (23–62 years of age) during their lifetime. Spiral computed tomography and/or magnetic resonance imaging of brain was performed in all patients. MR venography was performed in 3 patients. 3D TOF MR angiography was performed in 4 patients, in 3 of which an enhanced signal from thrombosed sinuses and veins was marked while obtaining arterial images. Computed tomographic angiography of brain with contrast agent bolus was performed in 4 patients. In 3 of these patients, filling defects in sagittal and transverse sinuses along with typical changes were revealed on MRI. At an acute intracranial hypertension, this sign can be considered as outcome of the cerebral venous sinus thrombosis if an enhanced signal in the projection of these sinuses is revealed on T1- and T2-weighted images as well as FLAIR obtained at standard MRI performed during subacute phase (in a duration ranging from 5–7 days to 30–35 days). This process can occasionally be accompanied by venous infarction or development of cerebral oedema in the region of thrombosed sinus.

Results. Cerebral sinus thrombosis was suspected in 4 out of 9 cases while performing CT scan of brain; wh ereas, the diagnosis was confirmed in 6 patients in standard MRI. CT angiography with contrast agent bolus or MR angiography and MR venography was required in the rest patients.

Conclusion. The diagnostic algorithm in patients suspected with cerebral venous thrombosis should include the following: CT during acute phase, standard MRI during subacute phase, and if necessary, MR angiography, MR venography, or CT angiography with contrast agent bolus.


1. Неймарк Е.З. Тромбозы внутричерепных синусов и вен. М.: Медицина; 1975.
2. Caso V., Agnelli G., Paciaroni M. Handbook on cerebral venous thrombosis. Frontiers of Neurology and Neuroscience. 2008; 23.
3. Coutinho J.M., Zuurbier S.M., Aramideh M., Stam J. The incidence of cerebral venous thrombosis among adults: a cross-sectional hospital based
study: 21 European Stroke Conference. Lisbon, May 22–25, 2012: 8.
4. Астапенко А.В., Короткевич Е.А., Антиперович Т.Г. и др. Тромбоз церебральных вен и синусов. Медицинские новости. 2004; 8: 48–52.
5. Глебов М.В., Максимова М.Ю., Домашенко М.А., Брюхов В.В. Тромбозы церебральных венозных синусов. Анналы неврологии. 2011; 5
(1): 4–10.
6. Федин А.И. Избранные лекции по амбулаторной неврологии. В кн. Материалы ХХ Национального конгресса «Человек и лекарство».
М.; 2013.
7. Фурсова Л.А. Тромбозы церебральных вен и синусов. ARS MEDICA. 2009; 3 (13): 106–18.
8. Корниенко В.Н., Пронин И.Н. Сосудистые заболевания и мальформации головного мозга. В кн. Диагностическая нейрорадиология.
М.; 2009; I (5): 311–4.
9. Masuhr F., Mehraein S., Einhaupl K. Cerebral venous and sinus thrombosis. J. Neurol. 2004; 251: 11–23.
10. Stam J. Cerebral venous and sinus thrombosis: incidence and causes in ischemic stroke. Adv. Neurol. 2003; 92: 225–32.
11. Путилина М.В., Ермошкина Н.Ю. Тромбоз венозных синусов. Особенности диагностики. Неврология. 2008; 2: 38–42.
12. Ding H.Y., Jiang J.Z., Dong Q. Clinical features and outcome of cerebral vein and sinus thrombosis: an analysis of 60 cases: 21 European Stroke
Conference. Lisbon, May 22–25, 2012: 357.
13. Rocha H., Sampaio L., Abreu P., Carvalho M. Cerebral venous sinus thrombosis in the last 5,5 years in a Portuguese hospital: 21 European Stroke
Conference. Lisbon, May 22–25, 2012: 352.
14. Coutinho J.M., Zuurbier S.M., van den Berg R., Troost D. et al. Small juxtacortical hemorrhages specific for cerebral venous thrombosis: 21
European Stroke Conference. Lisbon, May 22–25, 2012: 9.
15. Савельева Л.А., Тулупов А.А. Особенности венозного оттока от головного мозга по данным магнитно-резонансной ангиографии.
Вестник Новосибирского государственного университета. Серия: Биология, клиническая медицина. 2009; 7 (1): 36–40.
16. Семенов С.Е., Абалмасов В.Г. Диагностика нарушений церебрального венозного кровообращения с применением магнитно-
резонансной венографии. Журнал неврологии и психиатрии им. С.С. Корсакова. 2000; 10: 44–50.
17. Тулупов А.А., Савельева Л.А., Горев В.Н. Функциональный анализ венозного оттока от головного мозга в условиях нормы по данным
магнитно-резонансной томографии. Клиническая физиология кровообращения. 2009; 2: 65–70.
18. Чучин М.Ю. Тромбоз латерального венозного синуса как причина головокружения у детей. Детская больница. 2011; 2: 11–4.
19. Coelho P., Geraldes R., Canhao P. Mastoid air sinus abnormalities associated with lateral sinus thrombosis: 21 European Stroke Conference.
Lisbon, May 22–25, 2012: 360–1.

 If you found mistakes, select text and press Alt+A