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At least 451 records · Page 25Linked to original sources
PubMed1990

Hereditary antithrombin III deficiency with a superior sagittal sinus thrombosis: evidence for a possible mutation starting in the mother of the propositus.

A patient with a superior sagittal sinus thrombosis (SSST) which occurred during the postpartum period is reported. Coagulation studies revealed persistently decreased antithrombin III (AT III) activity. Studies of AT III activity in her family revealed a hereditary AT III deficiency. Since AT III activity was normal in the grandparents of the propositus, the disorder in this family appears to be due to a spontaneous mutation occurring in the mother of the propositus.

Adult↗
PubMedDate not supplied

Superior sagittal sinus thrombosis in a patient with postdural puncture headache.

BACKGROUND AND OBJECTIVES: The occurrence of concomitant intracranial pathology in a patient with postdural puncture headache (PDPH) is rare. We present a patient who had a superior sagittal sinus thrombosis in addition to his PDPH. The signs and symptoms of intracranial pathology in patients with dural puncture headache, in addition to their postural headache, are discussed. CASE REPORT: A 32-year-old man with lymphoblastic lymphoma received treatment with daunorubicin, vincristine, and prednisone. He developed postural headache and severe nausea and vomiting after a diagnostic lumbar puncture. Magnetic resonance imaging (MRI) showed superior sagittal sinus (SSS) thrombosis and meningeal enhancement. An epidural blood patch was performed and enoxaparin was prescribed for 6 months. He has remained asymptomatic. CONCLUSIONS: Patients with PDPH have classic postural headache. The occurrence of additional signs and symptoms should alert the clinician to the presence of intracranial pathology. Patients with lymphoblastic lymphoma who had treatment with L-asparaginase and steroid are predisposed to the development of cortical venous thrombosis and may have this syndrome in addition to a dural puncture headache.

Adult↗
PubMed1995

Cerebral venous sinus thrombosis and antiphospholipid antibodies.

We report two cases of cerebral venous sinus thrombosis associated with an antibody to phospholipids, namely the lupus anticoagulant. Both patients later developed further immunologically mediated conditions. The importance of screening for the lupus anticoagulant in addition to anticardiolipin antibodies in this condition and the need for follow-up of such patients is discussed.

Adult↗
PubMed2003

Cerebral venous sinus thrombosis precipitated by Graves' disease and Factor V Leiden mutation.

We report a case of simultaneous presentation of cerebral venous sinus thrombosis and thyrotoxicosis in a 28 year-old female subsequently found to have the Factor V Leiden mutation. She made an excellent neurological recovery with anticoagulation. The mode of presentation of the case was surprising, as she had no thrombotic episodes in two previous pregnancies. This suggests that thyrotoxicosis may give rise to a hypercoagulable state.

Adult↗
PubMed1986

Superior sagittal sinus thrombosis: neuroradiological evaluation and clinical findings.

The spectrum of clinical signs in cases of superior sagittal sinus thrombosis includes not only focal neurological deficits, seizures and mental disturbances, but also symptoms which may lead to a diagnosis of pseudotumour cerebri (PTC). In 14 cases of angiographically (or autopsy) proven thrombosis of the superior sagittal or both lateral sinuses, the "empty triangle" sign on contrast CT examination was the most reliable sign, suggesting the diagnosis in 70%. Indirect CT signs (venous infarcts) were observed in all 8 patients with focal neurological signs, but appeared rather delayed in 3 cases. In contrast, patients with "benign" intracranial hypertension or PTC (6 cases) had normal unenhanced scans (4 cases) or showed slight diffuse brain oedema (2 cases). Magnetic resonance imaging was performed in 4 patients with findings suggestive of intravascular coagulation; however, due to the complexity of flow phenomena, further studies employing this new imaging technique will first have to be performed. Thus, angiography remains the best diagnostic tool and should not be delayed if there is a clinical suspicion of thrombosis.

Adolescent↗
PubMed2000

Sigmoid sinus thrombosis after mild closed head injury in an infant: diagnosis by magnetic resonance imaging in the acute phase--case report.

Intracranial sinus thrombosis following a mild closed head injury without a skull fracture or intracranial hematoma is extremely rare. A 23-month-old girl presented with vomiting and gait ataxia 1 day after occipital trauma. Computed tomography revealed a slightly increased density area in the region of the left sigmoid sinus. T1-weighted magnetic resonance (MR) imaging demonstrated an isointense area in the left sigmoid sinus and T2-weighted imaging showed a hyperintense area reflecting the characteristics of oxyhemoglobin. MR angiography and cerebral angiography indicated occlusion of the left sigmoid sinus. After 4 days of conservative treatment, her symptoms subsided completely. Follow-up MR angiography and cerebral angiography showed recanalization of the sigmoid sinus. The MR images and MR angiograms were useful for both early diagnosis and follow-up. Treatment should reflect the severity of individual cases, and early diagnosis will help achieve a good outcome.

Acute Disease↗
PubMed1998

[Value of cranial MRI in the follow-up of dural sinus thrombosis].

INTRODUCTION: At the present time it is well established that cranial magnetic resonance (MR) is the imaging technique of choice for diagnosis of thrombosis of the dural sinuses. However, few studies have been done to evaluate its role in follow-up in this cerebrovascular disorder. OBJECTIVE: To assess the alterations in resonance signal in follow-up of patients with thrombosis of the dural sinuses and the clinical correlation of this. MATERIAL AND METHODS: We reviewed the clinical histories of 12 patients diagnosed on cranial MR as having thrombosis of the dural sinuses; 8 cases were also seen again six months later. The cranial MR study was done using a 1.5 or 1.0 T superconductive apparatus to do measured spin-echo sequences (SE) in T1 and T2 in sagittal, transverse and coronal planes. The time elapsed between diagnosis on MR and clinical diagnosis was between 24 hours and 6 months. RESULTS: All patients had stronger resonance signals in T1 and T2 indicating a subacute phase of the thrombosis (oxidative conversion of deoxyhaemoglobin to methoxyhaemoglobin) and complete absence of blood flow in the sinuses. The eight patients seen again after six months were found to be normal on neurological. On cranial MR partial recanalization was seen in 5 of these (62%). CONCLUSION: Changes in the resonance signal persist for a long time both with and without signs of recanalization. This finding does not affect the medium term clinical course.

Adult↗
PubMed2004

Cerebral vein and sinus thrombosis in Isfahan-Iran: a changing profile.

OBJECTIVES: This study was performed to investigate the clinical presentation and predisposing factors for cerebral vein and sinus thrombosis (CVST) in Isfahan, Iran. METHODS: Data from the records of all patients with CVST referred to the largest tertiary-care hospital of Isfahan during a five-year period (1997 to 2001) were extracted and reviewed. RESULTS: The number of cases with CVST diagnosed annually was 6, 9, 11, 14 and 15 patients, respectively. Thirteen men and 42 women were diagnosed to have CVST with the mean age of 35.1 +/- 3.8 and 28.7 +/- 1.3 years, respectively. Headache was the most frequent complaint (95%) and 63% of patients had focal neurological symptoms, including seizure (58%). Among possible predisposing factors, oral contraceptive pill was the most prevalent one, which was used by 38.1% of affected women for a period of as short as 1-3 months. Anticardiolipin antibodies were detected in 14% of patients. CONCLUSIONS: It seems that the annual incidence of CVST is increasing in Isfahan, perhaps due to more extensive intake of oral contraceptive pills and usage of more accurate modern diagnostic tools. The use of oral contraceptive pills was the most frequent predisposing factor; infections and postpartum factors were infrequently observed. Despite other reports from the Middle East, Behçet's disease is not a principal risk factor for CVST in Isfahani patients.

Adolescent↗
PubMed2004

Cerebral venous and dural sinus thrombosis in severe falciparum malaria.

Common causes of coma in falciparum malaria are cerebral malaria, hypoglycaemia and electrolyte disturbances. Focal deficits due to arterial infarcts may sometimes occur in children, but are rare in adults. Three adults with falciparum malaria who had fever, altered consciousness and focal neurological deficits (one of whom also had seizures) are being reported here. CT scan of the brain revealed haemorrhagic infarction of the cerebral cortex and subcortical white matter with surrounding oedema suggestive of venous infarction in all three patients. The diagnosis of cerebral venous thrombosis was missed in the first patient, and was detected only at autopsy. In the next two patients, superior sagittal sinus thrombosis was confirmed angiographically. Only one patient survived; the other two died of increased intracranial pressure. Two of the three patients also had Plasmodium vivax co-infection. A hypercoagulable state resulting from severe malaria may be responsible for this rare and potentially fatal complication. Cerebral malaria may be associated with raised intracranial pressure due to cerebral oedema. Cerebral venous thrombosis may worsen this and adversely affect outcome. This diagnosis should be suspected in patients with severe malaria who develop focal neurological deficits and confirmed by appropriate imaging; judicious use of local thrombolytic therapy may help improve outcome.

Adult↗
PubMed1976

Traumatic lateral sinus thrombosis. Report of two cases.

Two cases with thrombosis of the transverse sinus caused by a fracture crossing the sinus are reported, and the roentgenological changes seen in cerebral angiography are discussed. In 1 case, a filling defect was seen which at subsequent autopsy was found to correspond with an intraluminal thrombosis. In the other case, not verified at autopsy, the angiographic changes were consistent with a thrombosis of a transverse sinus.

Aged↗
PubMed2006

Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch.

BACKGROUND: It has been suggested that the risk for cerebral venous sinus thrombosis (CVST) may be greater among users of the contraceptive patch than among users of oral contraceptives (OCs). METHODS: From the PharMetrics database, we identified women aged 15-44 years who filled at least one prescription for either the contraceptive patch or desogestrel-containing, norgestimate-containing or levonorgestrel-containing OCs to assess the risk of CVST. The person-time of current exposure to each study drug, as well as the incidence rates (IRs) and incidence rate ratios (IRRs) of CVST, was calculated. RESULTS: We identified over 1 million users of the four study drugs. There were five cases of CVST among current users of desogestrel, seven cases among current users of norgestimate, two cases among current users of levonorgestrel and none among current users of the contraceptive patch. The IRs per 100,000 woman-years were 2.7 [95% confidence interval (95% CI)=0.9-6.3], 1.6 (95% CI=0.7-3.3), 0.7 (95% CI=0.1-2.4) and 0.0 (95% CI=0.0-4.8), respectively, in users of desogestrel, norgestimate, levonorgestrel and the contraceptive patch. There were two women who had CVST while not currently taking a hormonal contraceptive (IR=0.4 per 100,000 woman-years; 95% CI=0.1-1.3). The IRRs were 4.0 (95% CI=0.7-42.4) for desogestrel-containing versus levonorgestrel-containing OCs, and 2.4 (95% CI=0.5-24.0) for norgestimate-containing versus levonorgestrel-containing OCs. The IRR for the patch could not be calculated. CONCLUSIONS: There is no evidence of an increased risk of CVST in users of the contraceptive patch compared to users of levonorgestrel-containing OCs.

Administration, Cutaneous↗
PubMed2003

Thrombolytics for cerebral sinus thrombosis: a systematic review.

BACKGROUND AND PURPOSE: The use of thrombolytics is frequently mentioned in patients with cerebral venous or dural sinus thrombosis (CVDST) who deteriorate despite anticoagulant therapy. The aim of this review was to collect all the published information about their use in CVDST and to assess their efficacy and safety. METHODS: To find cases of CVDST treated with thrombolytics, we performed a MEDLINE search from 1966 to July 2001, checked all reference lists of studies found and hand searched volumes of 11 journals. Data was extracted by means of a standardised data extraction form. Proportions and 95% confidence intervals (CI) were calculated for outcomes and complications of thrombolytics. Cases were stratified according to variables that may influence the outcome and subgroups were compared by odds ratios and 95% CI. RESULTS: No randomised clinical trial (RCT) was found. Seventy-two studies (169 patients) were included. Urokinase was the thrombolytic most frequently administered (76%). In the majority of cases the thrombolytic was locally infused in the occluded sinus (88%). At discharge, 10 cases (7%; 95% CI 3-12%) were dependent and 9 cases (5%; 95% CI 2-9%) died. Intracranial haemorrhages occurred in 17% of cases. In 5% they were associated with clinical deterioration. Extracranial haemorrhages occurred in 21%, but only 2% required blood transfusion. CONCLUSIONS: Thrombolytics appeared to be reasonably safe in CVDST, but its efficacy cannot be assessed from the published data. Considering that CVDST is an uncommon disease, a randomised controlled trial to assess effectiveness and safety of local thrombolytics in cases of CVDST with poor prognosis is difficult but not impossible to undertake, on a multicentre international collaboration trial.

Clinical Trials as Topic↗
PubMedDate not supplied

Neonatal dural venous sinus thrombosis associated with central venous catheterization: CT and MR studies.

We report a case of extensive thrombosis of dural venous sinuses associated with placement of a central venous catheter in the jugular vein. Cases such as this one, though uncommon, underscore a potentially devastating complication associated with central venous catheterization and emphasize caution in catheter placement particularly in neonates.

Catheterization, Central Venous↗
PubMed1980

Hypopituitarism after aseptic cavernous sinus thrombosis.

A 44-year-old man developed aseptic thrombosis of the cavernous sinuses. He recovered but 3 months later presented a clinical and laboratory picture of pituitary insufficiency. After 3 years of hormonal replacement therapy, he was in good physical condition.

Adult↗
PubMed1982

Sagittal sinus thrombosis in early pregnancy.

A case of spontaneous thrombosis of the sagittal sinus occurring at 8 weeks' gestation and proved by angiography is reported. The literature was reviewed and etiology and management were discussed.

Adult↗