Cerebral venous thrombosis At high altitude

Cerebral Venous Thrombosis (CVT) is one of the rarest causes of stroke. It is described as complete or partial occlusion of the sinuses or cortical veins of the brain. A relationship between high altitude (HA) and cerebral venous thrombosis has been long suspected due to various case reports and studies, however, the exact underlying mechanisms and etiologies are highly complex and debatable. In this article review we discuss the incidence etiologies, risk factors, clinical presentations and management of CVT at high altitude. CVT majorly affects young people [2]. It presents with a wide variety of clinical presentations due to the complexity of cerebral venous architecture and a combination of edema, increased intracranial pressure and venous infarct. Numerous etiologies have been suggested for the incidence of CVT; varying from dehydration, increased blood viscosity leading to endothelial injury, immobility, inflammation, genetic expression of certain prothrombotic entities, triggering of the coagulation cascade, platelet dysfunction and underlying coagulation disorders. Individuals with history of coagulation abnormalities should be screened for underlying thrombophilias and cautiously ascend to higher altitudes. CVT should be considered in all neurological clinical presentations at high altitude. High altitude trekkers should be educated on how to keep hydrated and avoid immobility, exposure to extreme cold and seeking immediate help for symptoms like headache and disturbed mental status.