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Lateral sinus thrombosis in neurocysticercosis.

Cysticercosis is a frequent parasitic infection in developing countries including Nepal and is related to poverty, ignorance and pig-rearing practices at home in the community. A variety of structural involvements such as brain parenchyma, cerebellum, ventricular system, brain stem, meninges, subarachnoid space, spinal cord and orbit have been reported, but cysticercus involving the lateral sinus causing thrombosis is extremely rare.

Adolescent↗

Clinics in diagnostic imaging (103). Dural sinus thrombosis with cerebral venous infarction.

A 13-year-old boy had a history of severe headache for two weeks. He also had seizures and vomited many times. Neurological examination was normal except for bilateral papilloedema. Sagittal T1-weighted magnetic resonance (MR) images showed loss of the normal flow void in the superior sagittal sinus. There was hyperintensity, which came from subacute thrombosis in the posterior half of the superior sagittal sinus. MR venography confirmed loss of flow signal in the superior sagittal sinus. There was also thrombosis of the right transverse, right sigmoid, and left transverse sinuses, and haemorrhagic infarctions in the right frontal and left parietal regions. A diagnosis of dural sinus thrombosis with cerebral venous infarction was made. CT, MR imaging, MR venography, and CT venography findings are discussed in patients with cerebral venous thrombosis.

Adolescent↗

Superior sagittal sinus thrombosis treated with combined local thrombolytic and systemic anticoagulation therapy.

We recently encountered a patient with thrombosis of the superior sagittal sinus of an idiopathic cause. The patient was treated initially with combined local thrombolytic therapy through the burr hole over the superior sagittal sinus and systemic anticoagulant therapy. Continuous ventricular drainage and hyperbaric oxygenation therapy were used to control the increased intracranial pressure. The superior sagittal sinus was successfully recanalized. Whereas the patient suffered a complication with subacute subdural haematoma, he was successfully treated with the combination of these therapies. The rationale and approach are discussed.

Anticoagulants↗

[Superior sagittal sinus thrombosis complicated with multiple aneurysms presenting as subarachnoid hemorrhage. Case report].

A 48-year-old female suffered from severe headache, vomiting, and disturbance of consciousness. On admission, she was somnolent with mild paresis of the left leg. Precontrast computed tomography (CT) scans showed a high-density area in the left sylvian fissure and the posterior horn of the left lateral ventricle. Angiographically, a right middle cerebral artery aneurysm and a basilar artery aneurysm were recognized. Furthermore, on the venous phase of bilateral carotid angiograms, superior sagittal sinus (SSS) thrombosis was recognized. Subarachnoid hemorrhage (SAH) was probably induced by rupture of a dilated vein associated with SSS thrombosis, because high-density area on CT scan and location of the aneurysms were different. The patient was initially treated conservatively. Two months later, craniotomy was performed which did not disclose any trace of hemorrhage around the aneurysms and aneurysms themselves. Postoperatively, acute brain swelling and generalized convulsion were induced. The patient became ambulatory 5 months after surgery. In SAH cases, the venous phase should be examined at least in one side of the carotid arteries. In such a SAH case induced by venous thrombosis complicated by aneurysms it is very difficult to decide the timing of surgery for aneurysms.

Cerebral Angiography↗