Walsh & Hoyt: Cerebral Venous Thrombosis: Clinical Features

The clinical manifestations of CVT are extremely varied, depending on several factors. These include the site of obstruction (superficial or deep veins or dural sinuses); and the extent, the rate of occlusion, the underlying etiology, and the overall health or fragility of the patient. Thrombosis of cerebral veins is more likely to cause focal deficits due to infarction, whereas isolated involvement of dural sinuses more commonly produces increased intracranial pressure in the absence of focal signs. The rate of obstruction is often related to the underlying cause; for example, tumorous compression of a venous structure usually occurs slowly whereas thrombosis due to coagulopathy is typically more apoplectic. If obstruction is sufficiently slow to allow the development of adequate collateral drainage, symptoms and signs may be quite minimal. In general, infants and elderly or debilitated patients tend to fare worse in terms of morbidity and mortality.