Radiological Study of Cerebral Venous Sinus Thrombosis

Objective To investigate the origin, elongation and distribution of cerebral venous sinus thrombosis and the relationship between the thrombus itself and the consequent brain impairment. Material and Methods 34 cases of cerebral venous sinus thromboses (CVST) were retrospectively analyzed. The affected sinuses and their locations were listed out, and an evaluation was conducted on the MRI signal evolution of the thrombi based on SE T1WI sequence in the early stages, in order to see whether a chronological order of the affected sinuses. The difference of the consequent brain impairment was analyzed between those cases that the SSSs and the lateral sinuses were continuously affected and those patients only single side of lateral sinuses were involved. Pathophysiological view for the chronological order of thrombolic involvement of the major sinuses was evaluated using Fisher exact probabilities in 2×2 table test. Results In most cases, dural sinuses thromboses continuously involved more than one sinus or uninterruptedly extended in one sinus, most often affected the whole SSS and at least one side of the lateral sinuses at the same time with hyperintensity on T1WI images in the early stages. The occurrences rates of brain impairment in the temporal-occipital lobes were different for thromboses affecting the SSSs and the lateral sinuses and for those purely affecting the lateral sinuses, with P≈0.0004. Conclusion Thrombus continuely extend and involve multiple sinuses or uninterruptedly in one sinus, the SSS is the earliest place of thrombotic involvement. The thrombi often extend following the direction of the blood flow, the place where the thrombi originally occur is the location most easy to induce the corresponding brain impairment, while the place affected by the extending thrombi later is not easy to cause brain impairment.