Analysis of clinical misdiagnosis literature on cerebral venous sinus thrombosis

Abstract

Intracranial venous sinus thrombosis (cerebral venous sinus thrombosis, CVST) clinical manifestations and signs are often atypical, and the form of the disease is variable. With the improvement of diagnostic technology and clinical understanding, the detection rate of this disease is on the rise, but the misdiagnosis rate is still at a high level. The goal of our review article is to shed light on CVST to help reduce clinician’s misdiagnosis of the disease.

Methods

A total of 18 misdiagnosed CVST documents were published in Chinese medical journals from 2016 to 2020.

Results

The scope of misdiagnosis involves 22 diseases. The top three misdiagnosed diseases are cerebral hemorrhage, cerebral infarction, and encephalitis. The main reasons for misdiagnosis are the lack of understanding of the disease, the lack of understanding of the imaging manifestations of CVST, the lack of specific symptoms and signs, and the wrong diagnostic thinking methods to meet the diagnosis of common diseases. A total of 51 misdiagnosed cases described the relationship between misdiagnosis and disease outcome, of which 46 cases (90.20%) did not cause adverse consequences due to misdiagnosis.

Conclusion

It is crucial for clinicians to improve their understanding of CVST, and patients that present with headache, increased intracranial pressure, and focal neurological deficits could potentially have CVST and should be promptly sent to get cranial magnetic resonance imaging and magnetic resonance venography or digital subtraction angiography. The differential diagnosis should be checked and strengthened in order to reduce the occurrence of misdiagnosis.