Cerebral venous sinus thrombosis: With effective treatment, there is hope for a new life

Author: Wang Daming, Chief Physician of Beijing Hospital

Reviewer: Hu Wenli, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

Cerebral venous sinus thrombosis, as the name suggests, refers to the formation of blood clots in the cerebral venous sinus system. The venous sinus is an important channel for the brain's venous blood vessels to converge and return to the heart. Once these channels are blocked, it will lead to poor blood return to the brain, which will lead to serious consequences such as cerebral edema and increased intracranial pressure.

Cerebral venous sinus thrombosis is a rare but potentially fatal cerebrovascular disease that has gradually attracted the attention of the medical community. Once diagnosed, patients face complex treatment choices.

Internal medicine drug treatment is the basis and key to the treatment of cerebral venous sinus thrombosis, which mainly includes anticoagulant therapy and thrombolytic therapy. Anticoagulant therapy uses drugs to reduce blood coagulation, prevent the continued formation and expansion of thrombi, and provide important protection for the patient's recovery. Thrombolytic therapy uses thrombolytic drugs to dissolve the formed thrombi and restore the patency of the venous sinuses. It is suitable for patients in the early stages of thrombosis. It should be noted that the use time of thrombolytic therapy is relatively short and needs to be performed under the guidance of a professional doctor.

In the treatment of cerebral venous sinus thrombosis, the role of anticoagulant therapy cannot be underestimated. It not only prevents the further formation of thrombus and provides patients with a safety net to survive the acute period, but also promotes the formation of collateral circulation and ensures blood supply to the brain. The use of anticoagulants requires fine regulation to prevent the growth of thrombus and avoid the risk of bleeding, which requires the joint efforts and close monitoring of doctors and patients.

Figure 1 Original copyright image, no permission to reprint

In addition to medical drug treatment, interventional therapy plays an increasingly important role in the treatment of cerebral venous sinus thrombosis with its precision and efficiency. Local administration of drugs in the venous sinus through a catheter can more concentratedly exert the drug effect and improve the treatment effect. At the same time, interventional therapy can also use techniques such as balloon dilatation and stent placement to directly crush and aspirate thrombus fragments and restore the patency of the venous sinus. This method is especially suitable for critically ill patients and can quickly relieve the patient's symptoms and improve cerebral venous return.

Although surgery is relatively rarely used in the treatment of cerebral venous sinus thrombosis, it plays an irreplaceable role in emergency situations. For example, when patients have life-threatening conditions such as bleeding or brain herniation, decompressive craniectomy may be required to remove the hematoma and relieve intracranial pressure. In addition, for patients with large-area cerebral infarction, surgical means are sometimes required to reduce brain swelling and protect the patient's life safety.

Figure 2 Original copyright image, no permission to reprint

The goal of treating cerebral venous sinus thrombosis is not only to cure it, but also to minimize the sequelae. For patients in the new acute stage, timely and effective treatment can often bring satisfactory results, and many patients can fully recover.

However, for patients with long-term and recurrent disease, the complexity of treatment increases significantly. Thrombus may contain various components, from fresh to old and even organized, which makes treatment more difficult.

Even so, by establishing collateral circulation, many patients can still maintain a normal quality of life to a certain extent. However, it should not be ignored that some patients may have sequelae of varying degrees due to insufficient collateral circulation or complications such as bleeding and infarction.