Cerebral venous sinus thrombosis differential diagnosis: Difference between revisions
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|[[Digital subtraction angiography]] | |[[Digital subtraction angiography]] | ||
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* | * Hyperattenuating signal in the occluded [[sinus]] is the classic finding of [[sinus]] [[thrombosis]] in [[CT scan]]. | ||
* [[CT]] and [[MRI]] may identify [[Cerebral edema]] and venous [[infarction]] | * [[CT]] and [[MRI]] may identify [[Cerebral edema]] and venous [[infarction]]. | ||
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* CT [[venography]] detects the [[thrombus]], [[computed tomography]] with [[radiocontrast]] in the venous phase (CT venography or CTV) has a | * CT [[venography]] detects the [[thrombus]], [[computed tomography]] with [[radiocontrast]] in the venous phase (CT venography or CTV) has a higher efficacy than [[MRI]]. | ||
* [[Cerebral angiography]] | * [[Cerebral angiography]] can identify smaller clots and 'corkscrew appearance is typical for occluded [[veins]]. | ||
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|[[Subarachnoid hemorrhage]] | |[[Subarachnoid hemorrhage]] | ||
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* [[Headache|Severe headache]] (as | * [[Headache|Severe headache]] (patients demonstrate as the worst headache in their life) | ||
* Headache is the main symptom (often starts suddenly and starts after a popping or snapping feeling in the head) | * Headache is the main symptom (often starts suddenly and starts after a popping or snapping feeling in the head) | ||
* [[ | * [[Diplopia]] | ||
* [[Nausea]] | * [[Nausea]], [[vomiting]] | ||
* Symptoms of [[meningeal irritation]] | * Symptoms of [[meningeal irritation]] | ||
* Sudden [[Loss of consciousness|decreased level of consciousness]] | * Sudden [[Loss of consciousness|decreased level of consciousness]] | ||
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|[[Digital subtraction angiography]] | |[[Digital subtraction angiography]] | ||
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* | * Noncontrast head [[Computed tomography|computed tomography (CT)]] is the modality of choice for [[subarachnoid hemorrhage]], with or without [[lumbar puncture]].<sup>[[Subarachnoid hemorrhage CT#cite note-pmid7897421-1|[1]]]</sup> | ||
* [[Computed tomography|CT]] shows hyperattenuating material | * [[Computed tomography|CT]] shows [[subarachnoid space]] filled with hyperattenuating material. | ||
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* [[Lumbar puncture|Lumbar puncture (LP)]] is | * [[Lumbar puncture|Lumbar puncture (LP)]] is required in case of a strong suspicion of [[subarachnoid hemorrhage]]. LP will show: | ||
** Elevated opening pressure | ** Elevated opening pressure | ||
** Elevated [[Red blood cell|red blood cell (RBC)]] | ** Elevated [[Red blood cell|red blood cell (RBC)]] | ||
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* [[Fever]] | * [[Fever]] | ||
* [[Photophobia]] | * [[Photophobia]] | ||
* [[Phonophobia]] | * [[Phonophobia]] | ||
* [[Irritability]], [[altered mental status]] (in small children) | * [[Irritability]], [[altered mental status]] (in small children) | ||
|[[Lumbar puncture]] for [[CSF]] | |[[Lumbar puncture]] for [[CSF]] | ||
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* Diagnosis is based on clinical presentation in combination with [[CSF]] analysis. | * Diagnosis is based on clinical presentation in combination with [[CSF]] analysis. | ||
* [[CSF]] analysis is the | * [[CSF]] analysis is the test of choice. | ||
* For more information on [[CSF]] analysis in meningitis please [[Meningitis#Diagnosis|click here.]] | * For more information on [[CSF]] analysis in meningitis please [[Meningitis#Diagnosis|click here.]] | ||
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Revision as of 17:51, 1 August 2021
Cerebral venous sinus thrombosis Microchapters |
Differentiating Cerebral venous sinus thrombosis from other Diseases |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S
Overview
Cerebral venous sinus thrombosis is often get misdiagnosed due to the overlapping of symptoms with other neurological conditions
Differential Diagnosis
Cerebral venous sinus thrombosis should be differentiated from other diseases causing severe headache for example: [1][2][3][4][5][6][7][8][9][10]
Disease | Symptoms | Diagnosis | ||
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Gold Standard | CT/MRI | Other Investigation Findings | ||
Intracranial venous thrombosis |
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Digital subtraction angiography |
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Subarachnoid hemorrhage |
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Digital subtraction angiography |
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Meningitis |
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Lumbar puncture for CSF |
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Intracranial mass |
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MRI |
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Cerebral hemorrhage |
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CT scan without contrast |
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Cerebral Infarction | The symptoms of an ischemic stroke vary widely depending on the site and blood supply of the area involved. For more information on symptoms of ischemic stroke based on area involved please click here. | Cerebral angiography |
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Migraine |
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--- | Migraine is a clinical diagnosis that does not require any laboratory tests. Laboratory tests can be ordered to rule out any suspected coexistent metabolic problems or to determine the baseline status of the patient before initiation of migraine therapy. | |
Head injury |
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CT scan without contrast |
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Lymphocytic hypophysitis | Lymphocytic hypophysitis is most often seen in late pregnancy or the postpartum period with the following symptoms:
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Pituitary biopsy |
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Radiation injury |
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Surgical exploration including biopsy (histological confirmation) |
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PET scan
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References
- ↑ Endrit Ziu & Fassil Mesfin (2017). "Subarachnoid Hemorrhage". PMID 28722987.
- ↑ Benedikt Schwermer, Daniel Eschle & Constantine Bloch-Infanger (2017). "[Fever and Headache after a Vacation in Thailand]". Deutsche medizinische Wochenschrift (1946). 142 (14): 1063–1066. doi:10.1055/s-0043-106282. PMID 28728201.
- ↑ Otto Rapalino & Mark E. Mullins (2017). "Intracranial Infectious and Inflammatory Diseases Presenting as Neurosurgical Pathologies". Neurosurgery. doi:10.1093/neuros/nyx201. PMID 28575459.
- ↑ I. B. Komarova, V. P. Zykov, L. V. Ushakova, E. K. Nazarova, E. B. Novikova, O. V. Shuleshko & M. G. Samigulina (2017). "[Clinical and neuroimaging signs of cardioembolic stroke laboratory in children]". Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 117 (3. Vyp. 2): 11–19. doi:10.17116/jnevro20171173211-19. PMID 28665364.
- ↑ Sanjay Konakondla, Clemens M. Schirmer, Fengwu Li, Xiaogun Geng & Yuchuan Ding (2017). "New Developments in the Pathophysiology, Workup, and Diagnosis of Dural Venous Sinus Thrombosis (DVST) and a Systematic Review of Endovascular Treatments". Aging and disease. 8 (2): 136–148. doi:10.14336/AD.2016.0915. PMID 28400981.
- ↑ Priyanka Yadav, Alec L. Bradley & Jonathan H. Smith (2017). "Recognition of Chronic Migraine by Medicine Trainees: A Cross-Sectional Survey". Headache. doi:10.1111/head.13133. PMID 28653369.
- ↑ S. Wulffeld, L. S. Rasmussen, B. Hojlund Bech & J. Steinmetz (2017). "The effect of CT scanners in the trauma room - an observational study". Acta anaesthesiologica Scandinavica. 61 (7): 832–840. doi:10.1111/aas.12927. PMID 28635146.
- ↑ Johnston PC, Chew LS, Hamrahian AH, Kennedy L (2015). "Lymphocytic infundibulo-neurohypophysitis: a clinical overview". Endocrine. 50 (3): 531–6. doi:10.1007/s12020-015-0707-6. PMID 26219407.
- ↑ Makale MT, McDonald CR, Hattangadi-Gluth JA, Kesari S (2017). "Mechanisms of radiotherapy-associated cognitive disability in patients with brain tumours". Nat Rev Neurol. 13 (1): 52–64. doi:10.1038/nrneurol.2016.185. PMID 27982041.
- ↑ Sato N, Sze G, Endo K (1998). "Hypophysitis: endocrinologic and dynamic MR findings". AJNR Am J Neuroradiol. 19 (3): 439–44. PMID 9541295.