Abstract | Uvod: Cerebralna venska tromboza (CVT) izrazito je rijetka bolest kraniovertebralnog venskog
sustava koja se odnosi na začepljenje, odnosno okluziju venskih struktura u šupljini kranijuma , a
obuhvaća duralnu vensku trombozu, trombozu kortikalnih vena i trombozu dubokih cerebralnih
vena. CVT je rijedak poremećaj koji se godišnje dijagnosticira u 3 do 4 slučaja na milijun
pacijenata. Dokazano je kako žene oboljevaju češće od muškaraca što se pripisuje rizičnim
čimbenicima vezanim za spol, kao što su korištenje oralnih kontracepcijskih sredstava, trudnoća
te primjena hormonalne nadomjesne terapije. CVT ima širok spektar kliničkih prezentacijskih
simptoma te se sama dijagnoza nerijetko vrlo teško postavlja. Vodeće dvije metode u
dijagnosticiranju cerebralne venske tromboze jesu CT venografija te MR venografija. Tijekom
praćenja stanja i razvoja bolesti kod pacijenata s dijagnosticiranim CVT-om, istovremeno se
primjenjuju obje tehnike snimanja.
Cilj: Ciljevi ovoga istraživanja su utvrditi spolnu distribuciju pacijenata kod kojih je radiološki
potvrđena cerebralna venska tromboza, potom utvrditi učestalost razvoja venskog infarkta u
pacijenata s dijagnosticiranom cerebralnom venskom trombozom te utvrditi učestalost glavobolje
kao simptoma kod pacijenata s dijagnosticiranom cerebralnom venskom trombozom.
Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi pacijenti koji su bili
podvrgnuti CT ili MR venografiji u razdoblju od 1.1.2018. do 31.12.2023. godine. Iz elektroničkih
medicinskih zapisa (dobivenih iz IBIS-a) zabilježeni su demografski podaci (dob i spol) te podaci
o kliničkoj prezentaciji bolesti pri čemu je posebno obraćena pozornost na pojavu glavobolje kao
simptoma bolesti te na razvoj venskog infarkta nakon dijagnosticiranja CVT-a.
Rezultati: Od ukupnog broja pacijenata (134) u njih 21 (16%) je radiološki dijagnosticirana
cerebralna venska tromboza. Od pacijenata s potvrđenom CVT njih 12 (57.14%) je bilo ženskog
spola, a preostalih 9 (42.86%) muškog spola (P > 0,05). CVT je najčešće pogađala osobe između
20 i 50 godina, pri čemu je prosječna dob oboljelih pacijenata bila 46 ± 21 godina. Transverzalni
sinus bio je najčešće zahvaćen i to kod 8 (38.10%) pacijenata. Venski infarkt je bio prisutan kod 3
(14.29%) pacijenta s dijagnosticiranom cerebralnom venskom trombozom dok je glavobolja kao
simptom bila prisutna kod 10 (47.62%) pacijenata.
Zaključak: Retrospektivno istraživanje uključilo je sve pacijente podvrgnute CT ili MR
venografiji u vremenskog periodu od 2018. do 2023. godine te utvrdilo da je cerebralna venska
tromboza dijagnosticirana u njih 21 (16%). Iako su žene obolijevale češće, razlika nije bila
statistički značajna. Hipoteza da CVT često dovodi do razvoja venskog infarkta i hipoteza da
većina pacijenata ima glavobolju nisu potvrđene, što naglašava potrebu za daljnjim istraživanjima. |
Abstract (english) | Introduction: Cerebral venous thrombosis (CVT) is an extremely rare disease of the
craniovertebral venous system that refers to the obstruction or occlusion of venous structures
within the cranial cavity. It includes dural venous thrombosis, cortical vein thrombosis, and deep
cerebral vein thrombosis. CVT is a rare disorder, diagnosed annually in 3 to 4 cases per million
patients. It has been proven that women are more frequently affected than men, attributed to
gender-specific risk factors such as the use of oral contraceptives, pregnancy, and hormone
replacement therapy. CVT has a wide spectrum of clinical presentation symptoms, making the
diagnosis often very challenging. The leading two methods in diagnosing cerebral venous
thrombosis are CT venography and MR venography. During the monitoring of the condition and
disease progression in patients diagnosed with CVT, both imaging techniques are simultaneously
applied.
Aim: The aims of this study are to determine the gender distribution of patients with radiologically
confirmed cerebral venous thrombosis, to establish the frequency of venous infarction
development in patients diagnosed with cerebral venous thrombosis, and to determine the
prevalence of headache as a symptom in patients diagnosed with cerebral venous thrombosis.
Subjects and methods: This retrospective study includes all patients who underwent CT or MR
venography between January 1, 2018, and December 31, 2023. Demographic data (age and gender)
and clinical presentation details, with particular attention to the occurrence of headache as a
symptom and the development of venous infarction after the diagnosis of CVT, were recorded
from electronic medical records (obtained from IBIS).
Results: Out of the total number of patients (134), 21 (16%) were radiologically diagnosed with
cerebral venous thrombosis (CVT). Among the patients with confirmed CVT, 12 (57.14%) were
female, and the remaining 9 (42.86%) were male (P > 0.05). CVT most commonly affected
individuals between the ages of 20 and 50, with the average age of affected patients being 46 ± 21
years. The transverse sinus was the most frequently affected, occurring in 8 (38.10%) patients.
Venous infarction was present in 3 (14.29%) patients diagnosed with CVT, while headache as a
symptom was present in 10 (47.62%) patients.
Conclusion: The retrospective study included all patients who underwent CT or MR venography
from 2018 to 2023 and found that cerebral venous thrombosis (CVT) was diagnosed in 21 of them
(16%). Although women were more frequently affected, the difference was not statistically
significant. The hypotheses that CVT often leads to the development of venous infarction and that
the majority of patients experience headaches were not confirmed, highlighting the need for further
research. |