From the Guidelines
Viral infections can cause Cerebral Venous Sinus Thrombosis (CVST) through various mechanisms, including inflammation of the blood vessel walls, activation of the coagulation cascade, and endothelial damage. The provided evidence does not directly address the question of whether viral infections can cause CVST. However, based on general medical knowledge, it is known that viral infections can lead to inflammation and activation of the coagulation cascade, which can increase the risk of thrombosis, including CVST. Some studies have reported an association between viral infections, such as COVID-19, and CVST, although the exact mechanism is not fully understood 1. The evidence provided focuses on the diagnosis and management of cerebral venous thrombosis and sinusitis in children, but does not directly address the relationship between viral infections and CVST. However, it is known that viral infections can trigger a hypercoagulable state, which can increase the risk of CVST, and that patients with viral-associated CVST typically present with severe headache, altered mental status, seizures, or focal neurological deficits. Treatment generally includes anticoagulation therapy, management of increased intracranial pressure, and addressing the underlying viral infection when possible. Early recognition and treatment are crucial for improving outcomes in these cases. Key points to consider include:
- Viral infections can increase the risk of CVST through inflammation and activation of the coagulation cascade
- Patients with viral-associated CVST typically present with severe headache, altered mental status, seizures, or focal neurological deficits
- Treatment includes anticoagulation therapy, management of increased intracranial pressure, and addressing the underlying viral infection when possible
- Early recognition and treatment are crucial for improving outcomes in these cases.
From the Research
Viral Infections and CVST
- Viral infections, such as COVID-19, have been associated with an increased risk of cerebral venous sinus thrombosis (CVST) 2, 3, 4.
- The exact pathophysiology of CVST in viral infections is unknown, but it is thought to be related to a hypercoagulable state induced by the infection, which can lead to thrombosis 2, 4.
- CVST is a rare but potentially fatal complication of viral infections, and clinicians should be aware of the risk of thrombosis in patients with viral infections, regardless of the severity of the disease 3.
Risk Factors for CVST
- Infection is a known risk factor for CVST, and viral infections such as COVID-19 can increase the risk of CVST 2, 3, 4, 5, 6.
- Other risk factors for CVST include hypercoagulable states, conditions causing blood flow disturbances, and inflammation or infection 5, 6.
- Genetic thrombophilias, such as hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) variants, can also increase the risk of CVST 5.
Diagnosis and Treatment of CVST
- Early diagnosis of CVST is crucial to prevent serious outcomes, and neuroimaging is typically used to confirm the diagnosis 6.
- Treatment of CVST usually consists of anticoagulation with low-molecular-weight heparin and endovascular thrombolysis, but newer oral anticoagulants may also be used 6.
- Clinicians should maintain a high index of suspicion for CVST in patients with viral infections, particularly those with unexplained cerebral hemorrhage or infarcts with an atypical pattern for arterial occlusive disease 4.