[Medical Q&A] What symptoms should alert you to venous stroke?

Author: Gu Yaqin Xuanwu Hospital, Capital Medical University

Reviewer: Duan Jiangang, Chief Physician, Xuanwu Hospital, Capital Medical University

Venous stroke, also known as intracranial venous thrombosis, refers to thrombosis of intracranial veins or venous sinuses caused by various causes, which obstructs blood return or cerebrospinal fluid circulation, leading to a type of cerebrovascular disease characterized by intracranial hypertension and venous infarction or hemorrhage. The clinical manifestations of venous stroke are diverse and the symptoms are atypical, which are related to the location, degree, range and brain damage of the affected veins. Patients may present with acute, subacute or chronic onset, and may show the following symptoms.

1. Headache: The most common clinical manifestation, seen in 80% of venous stroke patients. Superior sagittal sinus thrombosis often presents with diffuse whole-head pain, while transverse sinus thrombosis can cause headache on the same side.

2. Epileptic seizures: About 40% of patients may experience epileptic seizures.

3. Focal neurological deficits: About 50% of venous stroke patients experience focal neurological deficits, which may be unilateral or bilateral, including limb paralysis, sensory impairment, aphasia, hemianopsia, etc.

4. Symptoms of high intracranial pressure: common in patients with venous stroke, including headache, nausea, vomiting, blurred vision, optic disc edema, etc.

5. Impaired consciousness: It is more common in patients with obvious brain damage or straight sinus/deep cerebral vein involvement. Coma in patients often indicates a poor prognosis.

In addition, patients with venous stroke may also experience clinical manifestations such as mental disorders, cognitive impairment, intracranial hypotension syndrome, and cavernous sinus syndrome.