Cerebral Venous Sinus Thrombosis

Cerebral venous sinus thrombosis (CVST) is a relatively uncommon but potentially devastating form of cerebrovascular disease involving thrombotic occlusion of the dural venous sinuses and/or cerebral cortical veins. CVST accounts for approximately 0.5-1% of all strokes but disproportionately affects younger patients, particularly women of childbearing age, with an estimated annual incidence of 3-4 per million in the general population and up to 12 per million in young women. Unlike arterial stroke, which results from sudden cessation of blood inflow to a defined vascular territory, CVST produces neurological injury through impaired venous outflow, creating a fundamentally different pathophysiological cascade. The dural venous sinuses are large, endothelium-lined channels within the layers of the dura mater that serve as the primary drainage pathways for cerebral venous blood. The superior sagittal sinus (SSS), which runs along the superior midline of the brain in the falx cerebri, is the most commonly affected sinus (62% of cases), followed by the transverse sinuses (45%), sigmoid sinuses (16%), and the deep venous system including the straight sinus, vein of Galen, and internal cerebral veins. Thrombus formation in the...