Welcome to the MedLibrary.org Wikipedia Supplement on Talk:Cerebral venous sinus thrombosis -- Please Click to Return to Front Page

	Cerebral venous sinus thrombosis has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can delist it, or ask for a reassessment.
April 17, 2008 Good article nominee Listed

	This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
GA	This page has been rated as GA-Class on the quality assessment scale
Mid	This article has been rated as Mid-importance on the importance assessment scale

	Medicine portal This article is within the scope of WikiProject Neurology. Please visit the project page for details or ask questions at the talk page.
GA	This page has been rated as GA-Class on the quality assessment scale
Mid	This article has been rated as Mid-importance on the importance assessment scale

Contents 1 Expansion 2 Argh 3 GA nom 4 Case reports 5 Images 6 Kids 7 Good article? 8 Success 9 History 10 Reordering per MEDMOS 11 Outcome 12 Oxford Handbook 13 More sources

Expansion

I have expanded the article with some sources at my disposition, including the quick review in the BMJ 2007. However, I am trying to get my hands on two further sources that I think seriously deserve consideration:

• Einhäupl K, Bousser MG, de Bruijn SF, et al (2006). "EFNS guideline on the treatment of cerebral venous and sinus thrombosis". Eur. J. Neurol. 13 (6): 553–9. doi:10.1111/j.1468-1331.2006.01398.x. PMID 16796579. 
• Stam J (2005). "Thrombosis of the cerebral veins and sinuses". N. Engl. J. Med. 352 (17): 1791–8. doi:10.1056/NEJMra042354. PMID 15858188. 
• The entire November 2006 edition of the J Pak Med Assoc seems to be devoted to this condition...
  • The entire content seems to be available free: http://www.jpma.org.pk/Issues_Articles/IssuesArticles.aspx?IssueID=66 JFW | T@lk 12:53, 15 June 2008 (UTC)

Thanks to Arcadian, Davidruben and indirectly Dave Iberri for starting this. JFW | T@lk 21:46, 24 October 2007 (UTC)

And: Dentali F, Gianni M, Crowther MA, Ageno W (2006). "Natural history of cerebral vein thrombosis: a systematic review". Blood 108 (4): 1129–34. doi:10.1182/blood-2005-12-4795. PMID 16609071.  JFW | T@lk 14:35, 26 October 2007 (UTC)

And: Kimber J (2002). "Cerebral venous sinus thrombosis". QJM : monthly journal of the Association of Physicians 95 (3): 137–42. PMID 11865168.  (FREE) JFW | T@lk 20:38, 28 October 2007 (UTC)

Argh

Just lost about 30 minutes work due to a caching problem typical of internet explorer. Have no time to continue further, but will do so tomorrow evening. JFW | T@lk 15:28, 26 October 2007 (UTC)

GA nom

Nominated for GA. Let's see. JFW | T@lk 18:31, 13 April 2008 (UTC)

Case reports

I have temporarily removed the following:

Other less well understood situations that increase the risk for cerebral sinus thrombosis are hyperthyroidism^[1] and myelodysplastic syndrome.^[2]

Both these states (hyperthyroidism and MDS) are only mentioned on the basis of case reports in a relatively low-impact factor publication. While I have not seen the fulltext, I don't think either of them demonstrate causality beyond "wow, our patient has two rare conditions, they must be related". JFW | T@lk 19:49, 13 April 2008 (UTC)

Images

I have asked our radiology spy Glitzy queen00 (talk · contribs) for some neuroimaging. JFW | T@lk 21:21, 13 April 2008 (UTC)

Kids

More about CVST in kids: PMID 11496852 (NEJM) and PMID 15699061 (Brain).

Obstetric prognosis of CVST: does it come back? PMID 12754362. JFW | T@lk 22:20, 13 April 2008 (UTC)

Good article?

It is indeed. Application has been successful, congratulations to all contributors. CycloneNimrod (talk) 11:53, 17 April 2008 (UTC)

Success

It took a little while to find one so this is the best I can get for now! I hope it meets all standards? As always, I'm happy to help! Heather 11:03, 25 April 2008 (UTC)Glitzy_queen00

Cheers! See your talkpage. JFW | T@lk 06:02, 29 April 2008 (UTC)

History

It is interesting that the history of CVST is hard to disentangle from idiopathic intracranial hypertension. A single case from 1887 and some from the 1930s seem to have led to the recognition that CVST is an independent entity. Does everyone with possible IIH still undergo a venogram? Full text at PMC: 2011899 has some historical content. JFW | T@lk 17:22, 27 May 2008 (UTC)

According to eMedicine, CT is now the central diagnostic technique in most disorders of cerebral venous drainage. However, it also says that "venography is worthwhile". Also: "Although CT is certainly adequate in most instances, MRI and magnetic resonance venography are effective in ruling out both a mass lesion and a potential dural sinus thrombosis." Regards, CycloneNimrod ^talk?_contribs? 08:40, 1 June 2008 (UTC)

Thanks. I was more interested in the historical question of when IIH and CVST became distinct clinical entities. We now know that IIH is not usually caused by infections, so was otitic hydrocephalus perhaps a missed case of otitis causing a sinus thrombosis? I will have a look at Emedicine to see if they provide historical context. JFW | T@lk 12:28, 1 June 2008 (UTC)

Thank heavens for PubMed Central:

Full text at PMC: 2011899 - child, 1956

Full text at PMC: 1026412 - 1980, a rather thorough summary of 795 cases, mostly post-mortem

Full text at PMC: 1802934 - Ray & Dunbar on using cerebral venography to distinguish from IIH

Problematically, no case has actually been labeled "first described" by any sources. JFW | T@lk 11:53, 15 June 2008 (UTC)

Reordering per MEDMOS

I'm not sure but I'm pretty sure risk factors come under epidemiology but currently they are listed under signs and symptoms. I'll wait for a reply before I change it (or before anyone else should change it) but I think it makes more sense to be in epidemiology. Regards, CycloneNimrod ^talk?_contribs? 16:14, 6 June 2008 (UTC)

Perhaps a brief summary in the intro (e.g. postpartum) and then moving it? JFW | T@lk 12:21, 8 June 2008 (UTC)

Outcome

Much recent work in Europe has been done in The Netherlands by the Cerebral Venous Sinus Thrombosis Study Group and more recently by the ISCVT. There are some highly relevant recent studies that are not cited in Stam (because the review predates these studies). PMID 10762517, however, appeared in 2000 but is not discussed prominently by the reviewer - it discusses functional outcomes, surely worth mentioning in a neurological condition previously diagnosed mostly after death.... JFW | T@lk 13:26, 15 June 2008 (UTC)

Oxford Handbook

Temporarily removed:

Progressive speech disorders, decreased cognition and decreasing visual acuity have also been reported amongst cases of CVST.^[3]

This was added to the section on raised intracranial pressure. Surely, these simply reflect symptoms we are already mentioning in people who are awake and talking. I will borrow someone's OHCM at work today and see in what context these symptoms are mentioned. JFW | T@lk 06:18, 16 June 2008 (UTC)

I have reviewed OHCM 7th edition page 472. It is a very comprehensive entry: it lists a large number of associated causes including some that we are not listing (unsure what their source is!) and suggests that particular symptoms could be localising signs in CVST. It also lists cavernous sinus thrombosis amongst the other forms, even though this seems to be generally regarded as a separate condition. Other interesting points are: (1) it insists on T2-weighed gradient echo sequences to identify cortical vein thromboses, (2) it lists a number of predictors for death from a study published in Stroke on 7 July 2005 but I cannot find the relevant paper[1], (3) it is vague on the importance of anticoagulation. JFW | T@lk 18:49, 18 June 2008 (UTC)

More sources

J Roy Soc Med carried a four-article series in 2000. A bit outdated, but there we go: http://www.ncbi.nlm.nih.gov/sites/entrez?orig_db=PubMed&db=pubmed&cmd=Search&TransSchema=title&term=93%5Bvolume%5D%20AND%205%5Bissue%5D%20AND%20Cerebral%20venous%20thrombosis JFW | T@lk 18:50, 26 June 2008 (UTC)

PMID 18625874 - Stam again breaking a lance for anticoagulation despite borderline statistics. Should prompt larger trials, methinks.

PMID 18340091 - slightly more data on thrombolysis, from ISCVT.

PMID 18309177 - seizures are likely to recur and one seizure + CVST therefore indicates need for antiepileptics.

Much of this is primary research, so it's time we wait for a further review. JFW | T@lk 20:25, 22 July 2008 (UTC)

Wikipedia content modification information:

• This page was last modified on 22 July 2008, at 20:25.

Wikipedia Authorship and Review

Wikipedia content provided here is not reviewed directly by MedLibrary.org. Wikipedia content is authored by an open community of volunteers and is not produced by or in any way affiliated with MedLibrary.org.

Wikipedia Usage Guidelines

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article on "Talk:Cerebral venous sinus thrombosis".

The URL for this specific entry is:

• http://medlibrary.org/medwiki/Talk:Cerebral_venous_sinus_thrombosis

All Wikipedia text is available under the terms of the GNU Free Documentation License. (See Copyrights for details). Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc.