IBCC Episode 102 - Cerebral Venous Thrombosis

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss cerebral venous sinus thrombosis, reframing it as "DVT of the brain" for broader appeal. They delve into the pathophysiology, highlighting the absence of valves in the brain's venous system and the potential for infarction due to obstruction. The discussion covers sequelae like increased intracranial pressure and communicating hydrocephalus, as well as the epidemiology, noting its rarity but significant impact on younger individuals. Risk factors such as thrombophilia, head and neck infections, and mechanical causes are examined, along with the challenges in diagnosis due to varied presentations. The hosts explore diagnostic tools like D-dimer tests, lumbar punctures, and imaging techniques, emphasizing the importance of CT venograms and MRIs. Treatment strategies, including anticoagulation, seizure management, and interventions for hydrocephalus and cerebral edema, are detailed, even addressing the controversial use of heparin in cases with hemorrhagic transformation. The episode concludes with a discussion on prognosis, highlighting factors influencing outcomes and underscoring the importance of early diagnosis and aggressive treatment.