gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Cerebral venous thrombosis - Discussion of surgical indications and role of venous Doppler ultrasound in 5 patients

Zerebrale Venenthrombose - Diskussion chirurgischer Indikationen und Rolle venösen Dopplerultraschalls bei 5 Patienten

Meeting Abstract

  • corresponding author Kay Mursch - Neurochirurgische Klinik, Zentralklinik Bad Berka
  • S. Trnovec - Neurochirurgische Klinik, Zentralklinik Bad Berka; LF UK Bratislava, Bratislava /SK
  • E. Stolz - Neurologische Klinik, Universitätsklinikum Gießen, Gießen
  • J. Behnke-Mursch - Neurochirurgische Klinik, Zentralklinik Bad Berka

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocPP.01.02

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Veröffentlicht: 23. April 2004

© 2004 Mursch et al.
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Cerebral venous thrombosis (CVT) can present with different symptoms and neuroradiological findings. This may lead to delayed treatment or inappropriate therapeutic strategies and worsened outcome. Thus, neurosurgeon should be aware of the dissimilar appearance of CVT to avoid pitfalls.


We present the cases of 5 patients who did require or were scheduled for surgical treatment of different appearances of CVT. In 4 of these patients, cerebral venous blood flow velocities were measured. Blood flow velocities in the deep cerebral veins (i.e. the basal vein of Rosenthal) can be obtained by transcranial Doppler or transcranial duplex sonography through the temporal bone window. Elevated flow velocities indicate cerebral venous blood flow disturbances such as thrombosis.


Two patients (f, 16 ys. of age, f, 35) suffering from deep CVT were diagnosed as thalamic tumours and were scheduled for stereotactic biopsy which was performed in one patient. A bilateral shunt was also placed in this patient. Two patients (f., 46 ys., m., 60 ys) underwent craniectomy because of a space-occupying intracerebral hematoma and brain oedema which caused cerebral herniation in sinus venous thrombosis. One patient (m., 14 ys.) was treated by decompressive craniectomy because of a frontal brain edema primarily diagnosed as encephalitis or tumour. The blood flow velocities in the basal vein exceeded the normal values by far in 3 patients who were examined by our method. In 2 of the patients, the flow direction was reversed. In all patients, occlusion of deep cerebral veins and/or sinuses was diagnosed by DSA or MRA and seemed to be the cause of the illness.


CVT is a differential diagnosis for patients presenting with neurosurgical emergencies. Transcranial venous ultrasound may contribute to the correct diagnosis in unclear cases.