Bloody Minded Episode 68 - The Gut Brain Axis | CVST, CRVO, Splanchnic Thrombosis and Other Rare Clots
Nov 11, 2025
Join an intriguing exploration of unusual clots like cerebral venous sinus thrombosis (CVST) and splanchnic vein thrombosis. Learn about the surprising causes and complex management strategies for these rare conditions. The hosts discuss critical symptoms, diagnostic imaging, and effective treatment options, including anticoagulation and surgery. They even touch on the fascinating Lemierre syndrome and the connection between ovarian thrombosis and pregnancy. Prepare for a wild ride through the lesser-known aspects of human plumbing!
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CVST Is A Key Young Stroke Cause
- Cerebral venous sinus thrombosis (CVST) is an important cause of stroke in young adults and is more common in women.
- Risk factors include pregnancy, OCP/HRT, obesity, local infections, iron deficiency and genetic thrombophilias.
Image Quickly And Anticoagulate CVST
- Diagnose CVST with vessel imaging: CT venogram quickly or MR venogram if available.
- Start therapeutic heparin promptly, even with small stable intracranial hemorrhage, and escalate to specialist care if needed.
Multidisciplinary Care Overrules Knee‑Jerk Stops
- Acute CVST with extensive features may need endovascular treatment or decompression and multidisciplinary input.
- Anticoagulation is often safe despite intracranial haemorrhage and should not be stopped without senior discussion.