A rare form of stroke that involves veins instead of arteries occurs more often than thought, this type of stroke is Cerebral Venous Thrombosis (CVT) caused by a clot in the Dural venous sinuses, which are veins that drain blood from the brain toward the heart. It is most common in women who are pregnant or taking oral contraceptives, and in people age 45 and younger.

The incidence of CVT among pregnant women and those who have recently given birth ranges from one in 2,500 to one in 10,000. The risk is greatest during the third trimester of pregnancy and in the first four weeks after giving birth. Up to 73 percent of CVT cases occur immediately after childbirth.

But women who’ve suffered CVT have a low risk of complications during future pregnancies. Patients with suspected CVT should have blood tests to determine if they have an inherited or acquired factor in the blood that increases the risk of blood clots (prothrombotic factor).

The most common symptoms of patients with CVT include headaches that progress in severity over days or weeks, and seizures. Some patients may develop a focal neurological deficit (weakness affecting the extremities, double vision, etc.), diagnosis of CVT can be challenging. It’s important to distinguish a hemorrhage caused by a ruptured brain artery from those associated with CVT. The mechanisms and treatment of the bleeding are quite different.

The statement outlined the approach doctors should take to diagnose and manage CVT:

• Clinical suspicion of CVT.
• MRI or alternative imaging technique at hospitals/medical centers with fewer resources.
• Confirm CVT.
• Begin Anticoagulation therapy (IV Heparin).
• Continue anticoagulation therapy, lasting three to 12 months to a lifetime.

Other options may be considered in patients who continue to experience neurological deterioration despite medical treatment. These options include surgery to temporarily remove a section of skull to relieve pressure on the brain (hemicraniectomy), or minimally invasive surgery to remove clots in the affected veins (endovascular treatment).