Cerebral Venous Thrombosis:Current Status and Challenges

Abstract

Background: Cerebral venous thrombosis (CVT) is a stroke type that primarily affects young individuals, with various risk factors and complex mechanisms. It accounts for 0.5% to 3% of all stroke cases and can significantly impact daily activities and quality of life.

Objective: This review aims to classify the etiology of CVT, assess its impact on prognosis, and evaluate the best treatment approaches. It also analyzes current issues in CVT management and proposes future directions for treatment.

Methods: A comprehensive review of the literature on CVT, focusing on risk factors, treatment strategies, and outcomes. The impact of anticoagulation therapy and endovascular interventions is examined.

Results: This review examines the various risk factors associated with CVT, including female-specific conditions, infections, autoimmune diseases, cancer, and mechanical triggers. It highlights the impact of these factors on the prognosis and outcomes of CVT. The effectiveness of anticoagulation therapy, both traditional and with direct oral anticoagulants, is discussed, along with the role of endovascular therapy in severe cases. The review also identifies current challenges in CVT management, such as incomplete thrombus clearance and the lack of standardized evaluation criteria for recanalization.

Conclusion: Further research is needed to optimize CVT management, improve patient outcomes, and enhance the quality of life for affected individuals.

Keywords: cerebral venous thrombosis; prognosis; risk factor; sinus thrombosis; treatment.

FIGURE 1

Classification of risk factors for cerebral venous thrombosis (CVT). CVT risk factors are categorized into four groups: short‐term factors, including woman‐specific factors, infections (by site and type), drug‐associated factors, and mechanical factors; long‐term factors, mainly autoimmune diseases, metabolic abnormalities, and tumors; permanent factors, primarily hereditary thrombophilia; and other unclassified influencing factors. Abbreviations; vWF, von Willebrand factor; FVIII, factor VIII; N2O, nitrious oxide; PC, protein C; PS, protein S; FVL, factor V Leiden; MTHFR, methylenetetrahydrofolate reductase; FIX, factor IX; RAI, retinoic acid‐induced; SLE, systemic lupus erythematosus; BS, Behçet's syndrome; SS, Sjögren's syndrome; IBD, inflammatory bowel disease; PNH, paroxysmal nocturnal hemoglobinuria; ITP, immune thrombocytopenia; VEXAS, (vacuoles, E1 enzyme, X‐linked, autoinflammatory, and somatic syndrome); AIHA, autoimmune hemolytic anemia; COVID‐19, Corona Virus Disease 2019; HIV, human immunodeficiency virus; CNS, central nervous system.