Cerebral venous thrombosis in otorhinolaryngology. Case report

Cover Page

Cite item

Full Text

Abstract

A violation of cerebral circulation, in which a blood clot forms in the venous system of the brain with the formation of an obstruction of the dural sinus, one or more veins of the brain is called cerebral venous thrombosis. Cerebral venous sinus thrombosis (CVT) is a rare venous thromboembolic event, which accounts for 5 cases per 1 million among adults and about 7 cases per 1 million among children, according to the International Study on Cerebral Vein and Dural Sinus Thrombosis. Women of childbearing age are more susceptible to the disease, which is probably due to hormonal changes during pregnancy, labor, as well as the concomitant effect of oral contraceptives (leading to hypercoagulation). In addition to the low prevalence of CVT, the variety of etiology, the diagnosis is complicated by the highly variable clinical picture of cerebral venous thrombosis. The clinical manifestations of CVT are very diverse and depend on the prevalence of thrombosis, the rate of formation of vein occlusion, the age of patients, and the etiological factor. The main symptom of CVT is an intense headache (92%) as a sign of developing intracranial hypertension. During more than 2 years of follow-up, the mortality rate from CVT was calculated – 8.3%, however, in more than 90% of cases the prognosis of the disease is favorable. Despite the favorable prognosis, without timely treatment of CVT, this is a potentially lethal disease, so the relevance of this topic is beyond doubt.

About the authors

Aleksandr A. Krivopalov

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Author for correspondence.
Email: krivopalov@list.ru
ORCID iD: 0000-0002-6047-4924

D. Sci. (Med.)

Russian Federation, Saint Petersburg

Aleksandr Yu. Shcherbuk

Saint Petersburg State University

Email: gkod@gmail.com
ORCID iD: 0000-0003-3049-1552

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg

Yurii A. Shcherbuk

Saint Petersburg State University

Email: 9361661@gmail.com
ORCID iD: 0000-0003-1945-6959

D. Sci. (Med.), Acad. RAS

Russian Federation, Saint Petersburg

Irina I. Sarkisyan

Saint Petersburg State Pediatric Medical University

Email: dr.sarkisyan.ir@mail.ru
ORCID iD: 0000-0001-8200-714X

Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Polina A. Shamkina

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Email: p.s.ent@bk.ru
ORCID iD: 0000-0003-4595-365X

Res. Assist.

Russian Federation, Saint Petersburg

Alexandra I. Glyshchenko

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Email: nocturne4@mail.ru
ORCID iD: 0000-0001-5209-7869

Graduate Student

Russian Federation, Saint Petersburg

References

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Figure 1. CT scan of the temporal bones in the axial projection (a–c) and GM without contrast enhancement in the axial projection (d–g) of patient K., 16 years old. Diagnosis: chronic epitympanitis on the left, cholesteatoma, mastoiditis, otogenic meningoencephalitis, thrombosis of the cavernous, sigmoid, transverse sinuses, subdural abscess of the posterior cranial fossa, SSVR. Infectious destruction with thinning and erosion of the posterior face of the temporal bone pyramid is determined - arrow (a), total absence of airiness of the cells of the left mastoid process (b, c), an extensive zone of destruction with the formation of a cavity (arrows) filled with soft tissue contents. On CT of the GM, thickening, tortuosity of the veins of the orbit, left-sided exophthalmos (d, e), increased signal intensity in the projection of the left sigmoid and transverse sinuses (d, e - arrows), edema of the GM substance, the left cerebellar hemisphere with displacement of the median structures of the GM are determined. Along the course of the cerebellar tentorium, an irregularly shaped hypointense zone (12–16 H units), a subdural abscess (f, g arrows) is determined; in the left hemisphere of the cerebellum, hypointense areas of the GM substance (foci of encephalitis) are determined.

Download (258KB)
3. Figure 2. CT scan of the temporal bones in the axial view (a), coronal view (b) and sagittal view (c) and CT without contrast in the axial view (d, g) of patient K., 16 years old, performed after surgical debridement of infection foci. Postoperative cavities of the middle ear and mastoid without inflammation (a, b). On CT scan of the brain, performed in dynamics 5 days after surgical treatment (d, e), no liquid formations were detected, swelling of the brain substance, displacement of the median structures is moderately pronounced. On the CT scan of the brain, performed on the 17th day after surgical sanitation of the foci of infection (f, g), formations, displacement of the median structures of the brain were not detected.

Download (332KB)

Copyright (c) 2022 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).