Cerebral Venous Thrombosis (CVT)

CVT occurs when a blood clot blocks a vein draining blood from the brain. As a result, pressure builds up in the blood vessels which results in headaches. This pressure buildup can lead to swelling and bleeding in the brain. Pressure can damage the brain tissue leading to a venous stroke. This type of stroke can cause numbness or weakness in the arm or legs, and trouble with speaking, seeing, and walking.

CVT is a less common type of stroke. Less than 1 in a hundred of all stroke syndromes are because of central venous thrombosis. CVT more commonly affects women under age 50. About 85 out of 100 people are independent after CVT. But some may experience longer-term issues with cognition, pain, fatigue, or mood. These effects may leave them unable to return to work or school.

What are common symptoms of cerebral venous thrombosis?

Symptoms of CVT may vary, depending on where the blood clot is. Symptoms may include severe headache, often with 1 or more of the following:

• nausea or vomiting
• seizures
• weakness
• sensory issues (numbness)
• speech problems
• difficulty with thinking (cognition)
• altered level of consciousness or confusion
• sudden vision changes such as visual loss, blurred or double vision

How is CVT treated?

Some people with CVT will be admitted to hospital and managed on a specialized acute stroke unit. Your healthcare team will determine the best immediate treatment and discuss long-term management plans with you. You may be treated with anticoagulant medicines. Anticoagulants help stop blood clots from forming or getting bigger. They are sometimes called blood thinners. As part of your treatment, you may need surgery. Your healthcare team will also help manage your symptoms such as headaches, vision changes, or seizures.

How can you care for yourself at home?

Your care needs after CVT will vary depending on how serious it was, what caused it, and how it impacts your function. Other important factors to consider in your care plan include work, school, and your home situation. Recognizing and managing any physical and cognitive (thinking) challenges will help you recover and help you become as well as you can after CVT. These challenges may include ongoing headaches, vision changes, seizure disorder, changes in cognition and mood, fatigue(tiredness), and changes in physical function.

Talk to your healthcare team about how to manage your health and care.

• Headaches or vision changes are common with CVT. For headaches rest in a quiet, dark room. Eat a healthy diet. Talk to your healthcare team about non-prescription or other treatments. Seek urgent medical attention if your headache pattern changes – particularly if they get worse after improving for a while or the headache won’t go away. Seek urgent medical attention if blurred or double vision is new or getting worse.
• Seizures can happen early or later with CVT. Seizures need to be assessed and treated by your healthcare team as soon as possible. Take prescribed medicines, get good quality sleep, manage stress, and limit alcohol intake to help prevent seizures. Talk to your healthcare team about restrictions in driving and other important safety precautions like wearing a medical alert bracelet.
• Mood and emotions can be intense, change quickly, and can sometimes be hard to control. Intense feelings are a normal reaction to a big health event, but they can also be a result of brain injury from a stroke. You’re also at higher risk for depression and anxiety. These mood changes can affect your recovery. There are treatments that can help. Ask to talk with a mental health professional to help you develop strategies that can help.
• Trouble with cognitive skills can occur following CVT. This can range from mild forgetfulness to more serious challenges with awareness, thinking, attention, memory, language, judgment, or problem solving. Talk to your healthcare team about your cognition and any difficulty you may be having. Try to be patient with yourself. Ask for help when you need it. There are treatment and management options that can help, such as cognitive rehabilitation.
• Low energy both in body and mind and a need for more sleep or rest can be an effect of CVT. When fatigue becomes long-lasting, overwhelming, and does not get better with rest, it is a medical condition called post-stroke fatigue. Talk to your healthcare team about how to set up routines for your day, arrange your space, build healthy eating and sleeping habits, and how to take part in safe exercise and leisure activity. Ask for help, your family and friends can help you get things done.
• Heavy menstrual bleeding can happen in people who menstruate and are taking an anticoagulant medicine. Talk with your healthcare team for how you can manage this.

If you have had a CVT and wish to become pregnant, it’s important to have a medical plan in place with your healthcare team. It is also recommended that you get counselling about family planning because of possible health risks.

When should you call for help?

Call 911anytime you think you may need emergency care. For example, call if you have signs of another stroke. These may include:

• Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
• Sudden vision changes.
• Sudden trouble talking.
• Sudden confusion or trouble understanding simple sentences.
• Sudden problems with walking or balance.
• A sudden, severe headache that is different from past headaches.
• Fainting.
• A seizure.

Call 911 even if these symptoms go away in a few minutes.

Call your doctor or seek immediate medical care if you have new symptoms that may be related to your stroke, such as falls or trouble swallowing.

Watch and call if you have been feeling sad, depressed, or hopeless, or you have lost interest in things that you usually enjoy or you have anxiety or fear that affects your life.

Watch closely for changes in your health and be sure to contact your doctor or nurse advice line if you have any problems.

To see this information online and learn more, visit MyHealth.Alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_cerebral_venous_thrombosis_ac.

For 24/7 nurse advice and general health information call Health Link at 811.

Current as of: November 21, 2024

Author: Neuroscience and Stroke Provincial Integration and Improvement Network, Alberta Health Services

This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.