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| Valerie Biousse's masterful summary of CRVO in the young person |
| In the young, CRVO occurs when problems arise in the vessel. If it is a vessel wall abnormality, it can be compressive vs. vasculitis. There can be decreased blood flow (i.e. CC fistula, venous sinus thrombosis - order imaging). There can be increased coagulability, caused by (1) inc viscosity (2) inc platelets, or (3) thrombophilia |
| Do clots occur more in the artery or vein? With inc platelets, the artery is more likely. With sickle cell, the artery is more likely. With inc viscosity, the vein is more likely: With protein C, protein S, and antithrombin III deficiency, the vein is much more likely. With Factor V Leiden and prothrombin G mutation, the vein is much more likely. With antiphospholipid antibody syndrome, the artery is more likely, though you can also have venous occlusion. With homocysteine, the vein is more likely, though you can also have arterial occlusion. In addition to ordering cbc, platelets, checking for anemia and the above blood factors, consider SPEP for multiple myeloma and Waldenstrom's. |