Cerebral venous thrombosis (CVT) is the development of a thrombosis resulting in partial or complete occlusion of a cerebral venous sinus or cortical vein. Obstruction of the cerebral venous system results in raised intracranial pressure and decreased cerebral perfusion and blood flow, which may lead to venous infarction. The severity of symptoms varies based on the degree and location of the venous occlusion. The superior sagittal sinus is the most frequently occluded cerebral vein. Patients with CVT classically present with some combination of headache, papilledema, seizures, and focal neurologic deficits (ie, cranial nerve palsies, hemiparesis, visual field deficits, hemisensory loss).

CVT most commonly presents in younger patients (ie, second to fourth decade of life) and is an important cause of stroke in this population. CVT is more prevalent in women than men (3:1). Risk factors for the development of CVT include exposure to estrogen-containing oral contraceptives, hypercoagulable states (genetic or acquired), pregnancy, malignancy, and head trauma.

The diagnosis of CVT is often delayed or missed. Patients have a favorable prognosis with timely diagnosis and treatment with anticoagulation. Delayed diagnosis and management may result in cerebral venous infarction with or without associated hemorrhage, lasting neurologic impairment, or death.