Diagnosis and Management of Cerebral Venous Thrombosis

Рет қаралды 73,325

The Neurophile (by Rutgers RWJMS Neurology)

Күн бұрын

00:00 - Intro
00:56 - Objectives
01:22 - Case
03:43 - Clinical Presentation
05:13 - Venous Vascular Territories
09:39 - Diagnostic Studies
13:07 - CT Venography
15:40 - MRI and MR Venography
20:48 - Summary of Imaging Signs
24:50 - D-Dimer
26:20 - Treatments
27:35 - Anticoagulation
32:12 - Endovascular Therapy
35:02 - Post Acute Care and Outcomes
40:40 - Summary: Treatment Algorithm
This video is intended for residents and fellows to understand the clinical presentation, diagnosis, treatment and prognosis of cerebral venous thrombosis.
Slides: drive.google.com/file/d/13vOR...
Created by:
Igor Rybinnik MD
Produced and narrated by:
Igor Rybinnik MD
Neurology Clerkship Director
Rutgers Robert Wood Johnson Medical School
Images adapted from, and redrawn whenever possible:
Kandel ER, et al. Principles of Neural Science 5th Edition. McGraw Hill, 2012.
Hacking C, Radiopaedia.org, rID: 80107
Stam J. NEJM 2005;352:1791-8
Smith D, Radiopaedia.org, rID: 74568
Ghoneim A, et al. Clinical Rad 2020;75:254-64
Lee SK, et al on behalf of SNIS. J NeuroIntervent Surg 2018;10:803-810.
Disclaimer: Please note that this material was simplified for educational purposes. For patient management, please review your clinical society's guidelines and engage expert consultation where appropriate. Also, the opinions of the presenters do not necessarily reflect those of Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, or Rutgers University as a whole.

Пікірлер: 113

@JameelHijazeen 3 жыл бұрын

Your videos are better than the best netflex series. I am astonished how presentations could be. You are creating a new era for medical presentations. Thank you! - Your Jordanian fan from Germany

@theneurophile 3 жыл бұрын

Thank you. I’m trying to redefine professional education one video at a time.

@JameelHijazeen 3 жыл бұрын

@@theneurophile 😅👍🏼👍🏼👍🏼

@Rad12315 5 ай бұрын

😅

@caiyu538 2 жыл бұрын

Always worth to revisit several times for these excellent tutorials.

@suyashsingh7469 3 жыл бұрын

Teaching can never get better than this... Love you loads

@durelltrago62 Жыл бұрын

Super! Far better than paid CME courses.

@dayanaemanuilova4589 3 жыл бұрын

As a radiology resident I find your presentations really helpful, thank you!

@markmuriithi1726 2 жыл бұрын

Daktari you are GOD's gift to radiology residents. Really appreciate the effort and time you put in you presentations

@coldmagnet 2 жыл бұрын

You have a gift, Sir!

@mayank9822 Жыл бұрын

Your presentations are a boon for neurology residents like us.

@centralperks6458 2 жыл бұрын

this video is amazing, it is already one of my favorites. Thank you for your videos

@zeljkacuk4498 3 жыл бұрын

This is the best lecture i've ever had. Thank you so so much, it was very helpful for us neuroresidents. Greetings from Croatia!

@damasceno9434 3 жыл бұрын

Such a great presentation! Thank you very much.!

@7iipx441 5 ай бұрын

Unbelievable!!! Thank you for providing such a great job for students and residents. Definitely going to recommend that to all.

@lizzydevon5634 2 жыл бұрын

This was truly amazing ❤️❤️❤️ I hope you never stop uploading videos. It was extremely helpful. Thankyou sir.

@gentleman7951 3 жыл бұрын

Great lecture Thank you dr rybinnik 🌷

@hongnhinguyen1840 2 жыл бұрын

This is an excellent lecture!

@diking8171 2 жыл бұрын

This ppt is really excellent! Thanks very much

@kons9172 3 жыл бұрын

Such a great job!!

@zedowabe 4 ай бұрын

What an excellent lecture is this!!!! Another important lecture let released here!! Thank uu!!

@eemanhilal Жыл бұрын

Wonderful presentation

@nilsoncorrea8474 8 ай бұрын

I have no words. You really have de gift to transmite the knowledge. Please sir, continue. Iam your fan.

@rafaelbarianineto 2 жыл бұрын

Thanks so much!! Excellent!

@mayfouad2954 Жыл бұрын

Just Perfekt!!!! Thanks alot☺️

@shivarajhunge-patil7701 3 жыл бұрын

Thank you sir🙏 nice presentation

@shuyetchoo480 Жыл бұрын

It is really helpful... great lecture !!! Thumbs up

@ashwanijoshi5199 Жыл бұрын

CCM/Neuro CC attending here preparing for boards. What an excellent talk and review!!. Now looking for the next talk. Thank You for all that you do for patient care and education.

@theneurophile Жыл бұрын

Thank you! I am glad you found this useful. Good luck on the boards.

@digambarpanchal1859 2 жыл бұрын

This is one of the best presentation I've ever seen! Thank you!

@amirjanah9873 2 жыл бұрын

You are a genius!! We can read about CSVT from multiple different sources, but we will never ever find a practical presentation like this. Thank you very much!

@theneurophile 2 жыл бұрын

Thank you! That was the point of this presentation.

@tulikanahar7441 Жыл бұрын

OKAY WOW! Hands down the best way to teach! Thank you so much.

@theneurophile Жыл бұрын

Thank you so much.

@joannc147 Жыл бұрын

Just an outsider here - family member has just been diagnosed and is being treated. Your video has given me a lot of hope - thank you! (She presented with a 4 day headache behind right eye followed by an apparent stroke losing cognitive ability and speech). ❤

@theneurophile Жыл бұрын

I'm sorry to hear of your troubles. I hope your family member gets better soon.

@pixie89 2 жыл бұрын

Thank you 🙏🏼

@radiologydarkroom7709 3 жыл бұрын

fantastic

@ivanbaracaldo1386 Жыл бұрын

Great work!! Keep it up

@Sri_ram17 Жыл бұрын

Excellent presentation sir

@darky5159122 2 жыл бұрын

more than beutiful !!!! thanks from heart

@luizanicastro1840 2 жыл бұрын

This was really brilliant!! You really helped me understand a very hard topic for my class tomorrow!! thank you so much, love from Brazil S2

@nadeemibrahim8778 Жыл бұрын

excellent

@nathgoody5905 2 жыл бұрын

Thanks a lot Sir, great lecture, Love from India 🇮🇳

@iftinaxmad781 8 ай бұрын

Thus is amazing lacture I feel like I watch my series episode waiting next events ❤❤❤❤❤❤ thanks dr

@MrZeid86 2 жыл бұрын

One like isn't enough,thank you for your effort

@maheswaranganesan4150 2 жыл бұрын

TOP CLASS PRESENTATION. YOUR FAN FROM INDIA...

@ltcbio1 2 жыл бұрын

I enjoyed and learned a lot from you video, thanks. As a 62 male with no history of headaches and contracted covid thanksgiving 2021, I have been suffering not post covid, but (maybe coincidental) post booster and flu shot, I have been suffering ever since. I have had a head CT scan that did not show any smoking guns and scheduled for an MRI on 14 March. I recently started a two week course of amoxicillin. I have also started again on baby aspirin and ginger consumption as to help in the event of thrombosis (figure it can't hurt and only help). P.S. As a magician who uses comedy, I much appreciated your method of presentation despite my predicament. Thanks!!

@theneurophile 2 жыл бұрын

Thank you for the nice comments. I am sorry to hear about your troubles. I hope you fell better soon.

@ethankenney8878 3 жыл бұрын

I’m a new PA in NSGY and your videos have helped so much. I get so excited when the next one comes out. Thanks a million. What’s the next topic presentation?

@brainman709 3 жыл бұрын

Exactly!

@mohamedtarek3832 3 жыл бұрын

I want to know the way u made such a professional presentations like this ..great thanks to u for your efforts 👏👏

@theneurophile 3 жыл бұрын

Thank you. I will make a video about it at some point.

@baveshsiva7393 2 жыл бұрын

awesome video ever !!!! btw, what is the color that you have used on your slide doc??

@dr.mohammedmohammed7633 2 жыл бұрын

Here we go ,, Medical netflix ,, You really open new era of competition for Medical education wise ,, if this Paid version then I will be the first one subscriber ,, thanks for your hard work and keep going.

@theneurophile 2 жыл бұрын

Education will always be free.

@woudwyk 3 жыл бұрын

Fascinating. My case is almost identical to this. Experienced CVT at 28 attributed to birth control.

@theneurophile 3 жыл бұрын

I'm sorry to hear that. I hope you have recovered well.

@kamalghimire4148 3 жыл бұрын

Thank you for information... Currently admitted in hospital with transverse sinus thrombosis with venous infarction and under LMWH and Mannitol for raised icp..improving symptomatically..lets hope it will recanalize with no recurrence..

@theneurophile 3 жыл бұрын

I'm sorry to hear that. I hope you get better soon.

@kamalghimire4148 3 жыл бұрын

@@theneurophile thank you..

@hazemali2047 5 күн бұрын

Thank you for the video. The pdf that is linked to the video is not working very well after p.66

@andresbluebird 3 жыл бұрын

What program do you use to create your presentations? They are so high quality.

@theneurophile 3 жыл бұрын

I use PowerPoint and the Adobe Creative Cloud.

@turaycesur3099 2 жыл бұрын

Brilliant!! thanks a lot !! Which slide software do you use for the presentation sir?

@theneurophile 2 жыл бұрын

The latest version of PowerPoint

@ankushdhiman2962 10 ай бұрын

Sir, it shall be very useful if u start sharing pdf of your lectures too.... thank you

@theneurophile 10 ай бұрын

Sure. Slides are hyperlinked in the video description.

@raminvakili1038 2 жыл бұрын

thank you for sharing this video, one question: how long should we continue warfarin?

@theneurophile 2 жыл бұрын

Usually 3-6 months, but ultimate duration depends on the results of follow-up imaging and thrombophia workup

@niyazaali2362 Жыл бұрын

I'm also recently diagnosed with CVST

@theneurophile Жыл бұрын

I am sorry to hear that. I hope that you recover quickly.

@salocohen13 3 жыл бұрын

Great video! The picture in 8:40 (cavernous sinus) is incorrect. V2 is not inside the cavernous sinus.

@theneurophile 3 жыл бұрын

I beg to differ. Maxillary division is inside the cavernous sinus according to Netter's Anatomy atlas.

@nedjlabou4730 2 жыл бұрын

Think you very much. Could you please indicate the relevant references?

@theneurophile 2 жыл бұрын

The references are in small font on the relevant slides, but I can add them to the description.

@reloadedvader 3 жыл бұрын

Hiii, greetings from India. Very useful presentation!! I am a resident physician of Int Medicine. We start Inj Lmwh and on the second day, we start warfarin. What is the ideal time to add Warf.??

@theneurophile 3 жыл бұрын

The time to start warfarin depends on patient stability (both clinical and radiographical on follow-up imaging).

@user-zt6wt3jw9f 17 күн бұрын

I hope you can answer me. Does narrowing or blockage of a vein in the head cause nerve spasms?

@theneurophile 15 күн бұрын

I’m not sure what you mean by “nerve spasms”

@tomo8597 Жыл бұрын

My 17 yr old suffererd a stroke 2 years ago from this CVST. They weren’t able to treat it after being in the ICU for 16 hours before she suffered the stroke.

@theneurophile Жыл бұрын

I am very sorry to hear that. Kids are usually resilient, so I am hopefully that she has recovered well.

@saeeda7783 5 ай бұрын

Thanks for this amazing informative lecture.. May i know the app used in this presentation 😅

@theneurophile 5 ай бұрын

Sure. This was made in PowerPoint.

@saeeda7783 5 ай бұрын

@@theneurophile thank you, I’m an intensivist I gained a lot from knowledge from this amazing channel

@COMEDY00034 2 жыл бұрын

Hi sir I got same problem. What must I do

@theneurophile 2 жыл бұрын

I am sorry to hear that. The first step is to reach out to a neurologist to be evaluated.

@ifnotmewho148 Жыл бұрын

What about vaccine induced as in the J & J side effects listed by them? Are you seeing more of this now?

@theneurophile Жыл бұрын

Not really. CVT is reasonably rare, so even if the risk goes up a few percent, the absolute case numbers are still low.

@angelrani5981 2 жыл бұрын

U haven't discussed about blurred vision of patients?

@theneurophile 2 жыл бұрын

There is a long list of non-specific symptoms that CVT patients get. Blurred vision is one of those symptoms, but unfortunately it does not help in the diagnosis.

@vallepudivya4770 2 жыл бұрын

iam a patient of CVT..am having this problem since from 2years..it was attacked at the time of delivery with hypertension..as I want know this problem.. will not cure..am taking medicines till now

@theneurophile 2 жыл бұрын

I'm sorry to hear that you have cerebral venous thrombosis. There is a chance that medications can curing this condition but those chances are best discussed with your doctor.

@vwaran7580 2 күн бұрын

Sir, I had CVST and still I am taking oral anticoagulant with Debigat , levoacitrom. Around 5 years I have been taking...I have checked no genetically disorders... But my doctor advises me to take life long.... Is it needed to take the anticoagulant for life long

@theneurophile Күн бұрын

I’m sorry that you are experiencing this illness. It is difficult to make appropriate treatment recommendations in an internet post without properly evaluating a person and reviewing all the data. So, I recommend following with your doctor who knows your specific situation for the discussion regarding duration of anticoagulation.

@vwaran7580 Күн бұрын

Yes sir I understand the situation. Actually it happened in 2018. After two years, my doctor instructed me to give up the anti coagulation tablet acitrom and reduced my dosage 250g levitracitrom . During Covid pandemic he passed away. His successor who is also neurologist but not that experience of the former, asked to continue the tablet dabigat with increased dosage. In my case CVST on left and it was partially canalized with slight siderosis due to hemorrhage and now doing good. After 2018 there was no issue that has raised . But its been more than 5 years I have been taking the tablets. That's why I asked sir. At least your experience may guide me for further.

@user-ey4rh5sf2s 3 жыл бұрын

👍🌸💗

@BeenaKaKitchen Жыл бұрын

How can I contact u sir.. I want to discuss my MRV report plz

@theneurophile Жыл бұрын

For us doctors, it is very challenging to interpret a report or make any recommendations without interviewing and examining the patient. Scans must be interpreted in the context of the clinical story. So, I recommend that you either discuss the MRV with the doctor that ordered it (who presumably examined you) or make an appointment to see us for a full evaluation.

@BeenaKaKitchen Жыл бұрын

How can I talk to you? Where to contact u... I want to discuss my all symptoms with you plz..

@theneurophile Жыл бұрын

@@BeenaKaKitchen I am sorry but I cannot comment on your symptoms or MRI report without evaluating you in our clinic. If you are in New Jersey, I encourage you to make an appointment by calling 732-235-7733.

@BeenaKaKitchen Жыл бұрын

I live in Pakistan.. can I talk to you on call?

@Entertainingstuff313 Жыл бұрын

What Happened with the Secret Study?

@theneurophile Жыл бұрын

It hasn’t been completed yet.

@Entertainingstuff313 Жыл бұрын

@@theneurophile i was on call and we had this sagittal sinus thrombosis patient. (Proved on MRV) And this video helped me pick up the findings after watching it. SO INCREDIBLY HELPFUL. Thank you!

@Mr_3raqi 2 жыл бұрын

33:17 "a decade ago" i was thinking more like 1990s 😂😂 not 2012...

@balrajstrawberry Жыл бұрын

How your making ppt sir

@theneurophile Жыл бұрын

I just use the usual PowerPoint that comes with Office 365. Nothing special.

@amalsaleh1196 2 ай бұрын

So ct is not penifishial vib earl

@theneurophile 2 ай бұрын

Can you please clarify your question?

@hackerpro1415 2 жыл бұрын

I am with uncertain mood could speak not well sometime wonderful orator but suddenly not affording to speak satisfactorily .no rel as tin of connectivity in see ntence.lstene they also fail to to pick me afte one or two talks.toic also tuning off my grasp.feling s if my mind utter ly chained.and sleeping and if confront with new situation get taken by fear could not write also Vision is alsobluring.hadache barly bearable Fickle minds What I should eat prescribe me

@theneurophile 2 жыл бұрын

Unfortunately, I cannot make any prescriptions for patients I have not personally seen.