Venous Stroke

'Venous Stroke' or 'Cerebral Venous Sinus Thrombosis' is caused by blood clots blocking the veins in the brain. The veins in the brain drain blood from the brain into the heart. When the veins are blocked, the blood cannot drain normally and causes back pressure in the brain leading to all the symptoms. Although venous strokes account for about 1% of all the strokes across all age groups and about 3/4th of all the strokes in people younger than 50 years.

Causes

Any predisposing condition that leads to increased tendency for blood clot formation, can cause venous stroke. The stroke occurs across all age groups, from infants , pregnant women, cancer patients, patients with blood disorders to elderly patients. Women tend to be more often affected than men.

Predisposing conditions

• Infection
• Trauma
• Pregnancy, puerperium and birth control pill use
• Blood disorders that lead to increased tendency to form blood clots
• Bowel diseases such as Crohn's disease and Ulcerative colitis
• Cancer

Symptoms

1. Sudden weakness or numbness of face, arm or leg; especially if the numbness is all on one side of the body
2. Sudden confusion, trouble speaking or understanding
3. Sudden trouble seeing in one or both eyes
4. Sudden trouble walking, dizziness, loss of balance or coordination
5. Sudden severe headache with no known cause
6. New onset seizures

How is a venous stroke diagnosed?

CT or MRI scans are required to diagnose the stroke. They help to identify the location of stroke and its severity. Occasionally, a cerebral angiogram may be done to confirm the diagnosis. Blood tests may be required to identify the predisposing condition.

Treatment

Heparin is a naturally occurring clot buster. It is the mainstay of treatment in all the patients with venous stroke. In patients with very high pressure in the head, a surgery may be needed to remove a part of the skull. In rare cases, an angiogram and mechanical retrieval of the clot may be needed.

Outcome

In general, the outcome of venous stroke is better than that of arterial stroke if the stroke is treated on time and the predisposing condition is identified and treated. complete recovery is possible in up to 80% of the patients.