CEREBRAL VENOUS SINUS THROMBOSIS: A COMPREHENSIVE REVIEW OF RISK FACTORS, DIAGNOSIS, MANAGEMENT, AND LONG-TERM OUTCOMES

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon but potentially life-threatening cerebrovascular disorder characterized by highly variable clinical presentations and diverse etiological factors. Recent advances in neuroimaging, anticoagulation strategies, and understanding of COVID-19-associated thrombosis have substantially improved disease recognition and management. This review aimed to comprehensively synthesize current evidence on the epidemiology, risk factors, pathophysiology, diagnosis, contemporary management, women-specific clinical considerations, long-term outcomes, and emerging therapeutic trends in CVST. A comprehensive literature review was conducted using peer reviewed articles, clinical guidelines, systematic reviews, randomized controlled trials, and observational studies retrieved from major scientific databases. Relevant evidence was identified using predefined search terms related to CVST, diagnosis, anticoagulation, neuroimaging, women-specific risk factors, COVID-19, and long-term outcomes. The selected studies were critically appraised and synthesized into major thematic domains. The evidence indicates that CVST is a multifactorial disorder resulting from inherited thrombophilia, acquired prothrombotic conditions, hormonal influences, and inflammatory processes. Early diagnosis using advanced neuroimaging and prompt anticoagulation remain the foundation of successful management. Direct oral anticoagulants and selective endovascular interventions have expanded therapeutic options, while recognition of women-specific risk factors and COVID-19-related thrombosis has enhanced individualized patient care. Although most patients achieve favorable functional recovery, persistent neurological sequelae and recurrence remain important long-term concerns. Continued advances in diagnostic technologies, personalized anticoagulation strategies, multidisciplinary management, and international collaborative research are expected to further improve the diagnosis, treatment, and long-term outcomes of patients with CVST.