What is Cortical Venous Thrombosis?

Cortical venous thrombosis is a vascular condition where the cortical veins that normally drain blood away from the cortex of the brain develop blockages, leading to a buildup of blood in the brain. This condition can cause a stroke and potentially serious complications, including death. Treatments are available, and the patient needs to receive medical care as soon as possible to prevent brain damage and irreversible changes to brain function.

Patients usually develop this condition because they have an underlying vascular problem like an existing clotting issue. Pregnancy can also increase the risk for cortical venous thrombosis. The patient usually reports a headache, sometimes with very rapid onset, and can have symptoms of cranial nerve palsy and stroke. These may include slurred speech, difficulty making facial expressions, and drooping eyelids. Other neurological deficits like memory loss and difficulty controlling the extremities can also develop.

A medical imaging study of the brain may reveal blockages in the cortical veins, decreased blood flow in the involved region of the brain, and swelling. The doctor can also order the use of contrast material to highlight blood vessels, looking specifically for the source of the blockage. Treatment for cortical venous thrombosis usually involves giving the patient anticoagulants to allow the blood to start flowing more normally. The doctor may also consider clot-busting medications made from enzymes that will dissolve the clot. If the pressure inside the skull starts to rise, a surgeon can implant a shunt to drain fluid and relieve the pressure.

The immediate concern with cortical venous thrombosis is stabilizing the patient and preventing a stroke, if the patient has not already had one. Once the patient starts to get better, the doctor can evaluate potential causes and determine if the patient needs additional medical care. This could involve anticoagulant therapy or a change in how an obstetrician manages a pregnancy, with the goal of preventing a recurrence. A neurologist will also want to see the patient for follow-up to see if she is responding to treatment and to make any necessary adjustments to the long-term treatment plan.

Whenever someone exhibits symptoms of a neurological problem, it is important to receive an evaluation, especially if the person has any recent history of head trauma or vascular disease. Brain tissue needs an ample supply of oxygen and nutrients, and even relatively short deprivations can cause serious long-term complications. In the case of cortical venous thrombosis, the patient could lose significant brain function without prompt treatment.