Dural venous sinus thrombosis (DVST) is a rare type of stroke. It’s caused by a blood clot that reduces or blocks the flow of blood in one of the dural venous sinuses. This, in turn, can disrupt the circulation of blood to the brain.
Dural venous sinus thrombosis (DVST) is when a blood clot affects one of the dural venous sinuses. These sinuses drain oxygen-depleted blood from your brain. If not treated quickly, it can have potentially serious health effects.
DVST is often more commonly referred to as cerebral venous thrombosis. It’s technically a rare type of stroke, accounting for about 0.5% to 1% of hospital stroke admissions.
This article helps explain what causes DVST, what the risk factors and symptoms are, and how it’s diagnosed and treated.
DVST is caused by a blood clot that reduces or blocks the flow of blood in one of the dural venous sinuses.
When a blood clot is present in the dural venous sinuses, it disrupts the system through which blood circulates in the brain. This means that brain tissue isn’t receiving as much oxygen as it should.
The effects of DVST can cause swelling, called edema, in brain tissue. DVST also affects the drainage of cerebral spinal fluid (CSF), the liquid that surrounds and cushions your brain and spinal cord.
Both the swelling of brain tissue and changes to the drainage of fluid can increase the pressure around the brain. This is called increased intracranial pressure and is a serious condition that can cause potentially life threatening complications.
Who gets dural venous sinus thrombosis?
While DVST can happen to anyone, some people are at a higher risk than others. Generally speaking, individuals who are at a higher risk of blood clots also have an increased risk of DVST. Risk factors include:
- being pregnant or postpartum
- taking oral contraceptives
- having an inherited bleeding disorder
Other potential causes of DVST include:
- a recent head injury or brain surgery
- an infection affecting the head, such as an ear infection, sinus infection, or meningitis
- certain inflammatory diseases, such as lupus or sarcoidosis
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Other potential symptoms of DVST include:
- nausea or vomiting
- vision problems, such as double vision or blurry vision
- muscle weakness or paralysis
- trouble with speech or language
- seizures
- confusion
- loss of consciousness
The diagnosis of DVST can be challenging. Not only is DVST rare, but the symptoms can vary between individuals or resemble those of more common conditions.
Imaging of the brain and its blood vessels is used to diagnose DVST. Using imaging, a doctor can visualize the blood clot in your dural venous sinus.
Imaging can include a CT scan or MRI scan. However, CT or MRI venography is more sensitive for helping to diagnose DVST. These techniques use a CT scan or MRI scan and the addition of a special dye to help better see your veins.
If the results of CT or MRI venography tests aren’t conclusive, a cerebral angiogram may be used. This uses X-rays and a special dye to create images of your blood vessels.
Laboratory tests are typically also done during the diagnostic process. However, these can’t confirm or rule out DVST on their own. Some examples of laboratory tests that may be done include:
The treatment of DVST involves giving supportive care and addressing the blood clot. Supportive care involves stabilizing your vital signs and managing any complications, such as seizures and increased intracranial pressure.
Seizures may be managed with anticonvulsants, while increased intracranial pressure may require intracranial pressure monitoring.
The blood clot can be addressed in a couple of ways. The first is the use of anticoagulants, which work to stop the blood clotting process.
Anticoagulant therapy for DVST typically involves the injection of an anticoagulant drug, often heparin, as soon as the diagnosis is confirmed.
You’ll then likely need to take an oral anticoagulant like warfarin as you recover. This helps prevent additional clots from forming.
Endovascular treatments may also be used in people who have severe symptoms and don’t improve with anticoagulant therapy. This involves either using medications to dissolve the clot or surgically removing the clot.
How serious is dural venous sinus thrombosis?
As it’s a type of stroke, DVST is a medical emergency, and 911 or local emergency services should be contacted. If left untreated, it can potentially lead to disability or death.
How common is dural venous sinus thrombosis?
DVST is rare. It’s estimated to affect only
What is the outlook for people who have dural venous sinus thrombosis?
When DVST is diagnosed and treated promptly, people with DVST have a favorable outlook. One 2020 review notes that 75% of people have a complete functional recovery.
DVST is when a blood clot affects the dural venous sinuses, which drain blood from your brain. It can be a life threatening condition if you don’t get prompt medical attention.
Due to the fact that it’s rare and the symptoms can vary from person to person, DVST can be hard to diagnose. However, once a diagnosis is made, it can often be effectively treated with anticoagulation therapy.
Headache is the main symptom of DVST. Seek care immediately if you have a sudden, intense headache, particularly if it continues to worsen. While it may not be due to DVST, it could be caused by another potentially serious medical condition.