In medicine, sinus vein thrombosis, or sinus thrombosis for short, refers to a thrombotic occlusion of a cerebral sinus. Sinus vein thrombosis usually affects women.
What is sinus vein thrombosis?
In sinus vein thrombosis, blood clots collect in the veins of the brain. However, clinical symptoms do not always result from occlusion of the large collecting veins. In principle, the venous system in the brain has a particularly high degree of flexibility. Often, however, sinus vein thrombosis results in what is known as blood congestion. In the context of venous congestion, blood accumulates increasingly in the area of the brain. Unless the blood volume is regulated, affected individuals may experience a stroke.
Causes
The causes of sinus vein thrombosis are relatively diverse. For example, infectious causes are primarily responsible for the occurrence of sinus vein thrombosis. The occurrence of sinus vein thrombosis is particularly frequently promoted by the so-called staphylococci. Resulting from an infection in the area of the face, the toxin of the bacterium can spread unhindered. Often, sinus vein thrombosis also appears as a late consequence of a so-called sinusitis. Inflammation of the paranasal sinuses is considered one of the most common causes of sinus vein thrombosis. However, in addition to infectious causes, generalized causes are mainly responsible for the occurrence of sinus vein thrombosis. Thus, the occurrence of thrombotic occlusion in the brain area is favored by measles disease, among other causes.
Symptoms, complaints, and signs
Medical professionals still find it difficult to clearly diagnose sinus vein thrombosis. This is because many initial symptoms are indicative of other conditions. Basically, a distinction is made between non-inflammatory and inflammatory sinus vein thrombosis. If a high fever is present, this indicates an inflammatory manifestation. The signs worsen the state of health over time. Finally, death may result from a stroke. Initially, severe headaches burden everyday life for several days. What sufferers usually interpret as a migraine turns out to be sinus vein thrombosis when combined with other complaints. Visual disturbances and unusual pain in the nose-eye area also occur. After this first phase, the signs change. Pain in the entire head and neck area is now possible. Seizures and epileptic blackouts develop. Patients vomit or feel nausea. In addition, psychological effects now become apparent. Close relatives and acquaintances perceive disturbances of consciousness and changes of character. Sinus vein thrombosis reaches its preliminary climax when paralysis occurs. Vision is weakened to such an extent that it comes to a standstill. If treatment continues to be ruled out, intracranial pressure develops in the head. Death sets in if affected individuals do not seek immediate medical attention.
Diagnosis and progression
Despite medical advances, sinus vein thrombosis can be relatively difficult to diagnose. Often, symptoms during an initial examination point to another condition. Even the determination of the so-called D-dimer level in the blood can never completely confirm an initial suspicion of sinus vein thrombosis. For this reason, so-called cross-sectional imaging diagnostics are used as an imaging procedure. Both computed tomography and magnetic resonance imaging can clearly detect so-called infarct zones as well as bleeding. Often, however, the administration of a so-called contrast agent is essential for better visualization of the individual areas. Sinus vein thrombosis can, however, not only be diagnosed by the individual imaging procedures. Thus, so-called laboratory diagnostics are often used as an alternative procedure. Among other things, the medical detection of the so-called C-reactive protein is becoming increasingly popular. This protein form is a special plasma protein that is formed in the liver. The C-reactive protein is often a clear indication of sinus vein thrombosis. However, the so-called blood sedimentation rate is also often determined as part of laboratory diagnostics.
Complications
In the worst case scenario, sinus vein thrombosis can result in the death of the patient. However, death can be avoided by heeding the warning signs of thrombosis and thus avoiding the further complications. Patients primarily suffer from very severe pain in the neck and head. This pain often spreads to other regions of the body. Furthermore, the patient may also experience convulsions or an epileptic seizure. Those affected also suffer from paralysis, which, however, only occurs temporarily and disappears after a short time. Visual disturbances or disturbances of consciousness can also be unpleasant side effects of sinus vein thrombosis and have a very negative impact on the patient’s quality of life. In the event of a loss of consciousness, the affected person may also injure himself in the event of a fall. Furthermore, the disease often leads to fever and thus to general fatigue and exhaustion. Treatment of sinus vein thrombosis is carried out with the help of medication. Complications do not occur. However, those affected by this disease are dependent on regular examinations in order to avoid further complications. It cannot be generally predicted whether this will result in a reduced life expectancy.
When should you see a doctor?
Sinus vein thrombosis requires medical treatment in all cases. It can come with this disease in the worst case to the death of the affected person, if the disease is not treated in time. This can also cause significant discomfort in the patient’s daily life, so sinus vein thrombosis should be treated at the first signs. A doctor should be consulted for this disease if the affected person suffers from a severe fever. In this case, there are various heart complaints, and the affected person is usually tired and also unable to concentrate. Also visual disturbances or various cramps can indicate sinus vein thrombosis and should be examined by a doctor if they occur without a particular reason and also do not disappear by themselves. Furthermore, severe nausea or severe disturbances of consciousness may also indicate sinus vein thrombosis. If these symptoms occur, a doctor must be consulted immediately. As a rule, the disease is treated by a cardiologist. In emergencies or if the symptoms are very severe, an emergency physician should be called or the hospital should be visited.
Treatment and therapy
Provided that sinus vein thrombosis has been diagnosed, immediate therapy is essential to prevent any late complications. As part of the therapy, the affected person is administered the drug heparin. The intravenous administration of heparin is intended to prevent the action of individual clotting factors in the blood. Until the so-called thromboplastin time has doubled, the affected persons must be treated with the agent heparin. The thromboplastin time is a special laboratory value that provides information about blood clotting. If the blood coagulation meets the set requirements, oral administration of anticoagulants is considered for a period of about 6 months. Since sinus vein thrombosis is often associated with epileptic seizures, another agent is administered in addition to the anticoagulants. The administration of phenytoin is intended to minimize the risk of epileptic seizures. In the context of a reliable therapy, however, the treatment of sinus vein thrombosis is not the only focus. Thus, the cause of thrombotic occlusion in the brain area should always be treated. Provided that sinus vein thrombosis is based on an infection, affected individuals must take a fast-acting antibiotic.
Prevention
Complete recovery can be achieved in approximately 85 percent of all cases. Despite medical advances, sinus vein thrombosis cannot be actively prevented. However, if clinical symptoms develop, a physician should be consulted immediately. This is the only way to prevent possible late complications.
Aftercare
In the further course of treatment with anticoagulants (drugs to inhibit blood clotting – for example, heparin or Marcumar), approximately 57 percent of those suffering from sinus vein thrombosis (SVT) are symptom-free after 6 months.This was confirmed by a study of the “International workshop on Cerebral Venous Thrombosis”. In the group of people who are reported to be symptom-free, follow-up care is aimed at preventing recurrence of SVT. This may require medication with a vitamin K antagonist for three to twelve months. In addition, doctors recommend annual screening for coagulation disorders. In addition, epilepsy occurs in ten percent of cases in the long-term course of the disease. Epilepsy can be treated with medication throughout life. During follow-up, electroencephalography (EEG) must be performed regularly (at least once a year). In addition, a blood sample should be taken to determine the level of medication. Only discontinuation of the medication can show whether the epilepsy persists. The acute mortality rate for SVT is about eight percent. In the event of the death of the sufferer, the subject of aftercare is survivor therapy with a focus on coping with grief. SVT manifests itself permanently in about four percent of those with the disease. Long-term treatment includes the use of medication for blood clotting. In addition to annual screening for coagulation disorders, an imaging examination (computed tomography or magnetic resonance imaging) is equally recommended here as follow-up.
What you can do yourself
In everyday life, make sure that the blood circulation does not experience any adverse effects from external influences or from adopting an unhealthy posture. Regular balancing movements and avoiding rigid postures is especially important. Congestion of the blood should be avoided under all circumstances. If long distances are covered, care should be taken to ensure that there is sufficient freedom of movement. Wearing thrombosis stockings as well as clothing that does not contribute to any disturbance of the blood flow is highly recommended in everyday life. In particular, wearing tight belts or other items that constrict parts of the body should be avoided. They do not have a good overall effect on the organism. Sport activities support the blood circulation in its activity. Often it is enough to perform minor movements of individual parts of the body in the course of the day to stimulate blood circulation. As soon as sensory disturbances occur or a tingling sensation is felt on the skin, the body posture should be changed and light exercises should be performed. In addition, the blood system can be positively supported by a targeted intake of certain foods. With foods such as pomegranates, nuts or legumes, the production of blood is stimulated. Furthermore, with foods containing caffeine or hot spices, an increase in blood pressure can be achieved. Therefore, the affected person can do something to improve his health in everyday life through his diet.
