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PubMed1984

CT diagnosis of thrombosis of dural sinuses in childhood.

This paper describes the CT findings in five cases of cerebral and cerebellar sinovenous occlusion. Characteristic CT findings are the visualisation of the thrombosed sinuses and veins, known as the "filled triangle" and the "cord sign" on the control scan, and the "empty triangle" with tentorial and gyral enhancement after contrast enhancement. The high incidence of thrombosed internal cerebral veins and superior cerebellar veins with sinus thrombosis in children is remarkable. CT with both control and contrast enhanced scans will probably provide the correct diagnosis in the majority of cases.

Child, Preschool↗
PubMed2003

[Septic thrombosis of the cavernous sinus due to folliculitis].

Sinus thrombosis is an acute life-threatening disease. While cavernous sinus thrombosis secondary to facial infections is described in the literature, it is uncommon. The key clinical characteristics are a facial infection, headache, chemosis and edema of the eyelid. The main differential diagnostic consideration is meningoencephalitis. Early diagnosis by angiography, magnetic resonance imaging and examination of CSF is important as treatment should be initiated as soon as possible in order to decrease morbidity and mortality. The mainstays of therapy are heparinization and appropriate intravenous antibiotic therapy.

Adult↗
PubMed1989

Septic thrombosis of the cavernous sinus: diagnosis with the aid of computed tomography.

A case of septic cavernous sinus thrombosis is described which was observed with high resolution computed tomography (CT). The significant CT findings in cavernous sinus thrombosis (CST) include irregular filling defects within a widened enhancing cavernous sinus. Concomitant findings are unilateral or bilateral swelling of the orbital soft tissues and sinusitis.

Adolescent↗
PubMed1986

[Dural arteriovenous fistulas of the posterior cerebral fossa and thrombosis of the lateral sinus. Discussion of their relations and treatment apropos of 2 cases].

Two cases of a posterior fossa dural arteriovenous malformation associated with a lateral sinus thrombosis are reported. In the first case, a right tentorial meningioma develops at the end of the superior sagittal sinus and on the transverse sinus which are occluded. A cranial bruit, heard by the patient four months after the surgical removal of the tumour, brings up a dural fistula supplied by the occipital, middle meningeal and pharyngeal arteries and drained away by cervical and cortical veins. Many attempts of extirpation and radiological embolization stop the bruit. In the second case, an increased intracranial pressure mixes up with an aphasia. A continuous emission doppler examination and a CT scan make likely a dural fistula. The malformation, which is associated to a left sigmoid sinus thrombosis, is fed by the occipital and middle meningeal arteries and drained by cortical veins to the cavernous sinus. The occipital artery ligation and a by-pass between the lateral sinus and the internal jugular vein cure the patient with a very good patency of the venous graft that holds up two years after. A few cases of the literature show the succession of the two vascular lesions and prove the primitive occurrence, either of the sinus occlusion, or of the dural fistula. A venous thrombosis might cause a fistula by the opening of physiological shunts of the dura-mater which consequently deviates the blood into the cortical veins, brings down the increased intracranial pressure and stops the thrombosis to spread.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

[Thrombosis of the superior longitudinal sinus in patients with AIDS. A review of the literature].

Cerebral dural sinus thrombosis (CSDT) is a rare disease with a high rate of mortality. Until now it has not been well-documented in patients with the acquired immunodeficiency syndrome (AIDS). Prompt diagnosis is essential for initiation of suitable treatment, especially in cases with progressive neurological involvement. The diagnostic methods include computed tomography (CT), magnetic resonance imaging (MRI) and conventional angiography. MRI and magnetic resonance angiography (MRA) have become the methods of choice because of their sensitivity and noninvasive nature. An unusual AIDS-patient, who at the time of CSDT presentation had an associated toxoplasmosis infection is described. To our knowledge, this is the first case of CSDT diagnosed by MRI and MRA in an AIDS patient. In the follow-up, MRI and MRA showed the repermeabilitation of the sinus thrombosis. Cerebral dural sinus thrombosis should be considered as a possible cause of neurological decline in a HIV-patient with central nervous system opportunistic infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Heparin treatment in sinus venous thrombosis.

Treatment of sinus venous thrombosis (SVT) is controversial. Although heparin has been used for this condition, many investigators have opposed its use because of the frequent occurrence of intracranial haemorrhage (ICH) and SVT. Therefore we have evaluated anticoagulation with adjusted-dose intravenous heparin for treatment of aseptic SVT in a randomised, blinded (patient and observer), placebo-controlled study in 20 patients (10 heparin, 10 placebo). The clinical course of the two groups, as judged by a newly designed SVT-severity scale, started to differ in favour of the heparin group after 3 days of treatment (p less than 0.05, Mann-Whitney U-test) and the difference remained significant (p less than 0.01) after 8 days of treatment. After 3 months, 8 of the heparin-treated patients had a complete clinical recovery and 2 had slight residual neurological deficits. In the placebo group, only 1 patient had a complete recovery, 6 patients had neurological deficits, and 3 patients died (p less than 0.01, modified Fisher's exact test). An additional retrospective study on the relation between heparin treatment and ICH in SVT patients was based on 102 patients, 43 of whom had an ICH. 27 of these patients were treated with dose-adjusted, intravenous heparin after the ICH. Of these 27 patients, 4 died (mortality 15%), and 14 patients completely recovered. Of the 13 patients that did not receive heparin after ICH, 9 died (mortality 69%) and only 3 patients completely recovered. We conclude that anticoagulation with dose-adjusted intravenous heparin is an effective treatment in patients with SVT and that ICH is not a contraindication to heparin treatment in these patients.

Adult↗
PubMed2004

Sinus pericranii: clinical and imaging findings in two cases of spontaneous partial thrombosis.

Sinus pericranii is an unusual venous anomaly characterized by communication of pericranial varicosities with an underlying dural sinus. We report two cases of spontaneous partial thrombosis of sinus pericranii presenting as focally tender, nonreducible mass lesions different in character from the baseline venous abnormality. CT, CT angiography, and CT venography (CTV) were performed in both cases. CTV was essential in depicting thrombi within the varicosities. MR (in one case) demonstrated the anomaly well, but the thrombus was not evident. Conservative therapy was instituted in both cases.

Adult↗
PubMed1977

Dynamic radionuclide scanning in the diagnosis of thrombosis of the superior sagittal sinus.

Two cases of superior sagittal sinus thrombosis were diagnosed using a new technique of dynamic radionuclide brain-imaging. With the patient's head in the posterior oblique position, and 80-lens optical camera records the appearance of radionuclides in the superior sagittal sinus. This technique is quick and noninvasive, and serial studies are easily performed. Dural sinus thrombosis is difficult to diagnose on clinical findings alone. Dynamic canning should be used to screen high risk patients, such as those having pseudotumor syndrome or clotting disorders and elderly patients having pulmonary emboli or unexplained deterioration of mental status.

Adult↗
PubMed1988

Septic thrombosis of the cavernous sinuses.

Cavernous sinus thrombosis may occur as a complication of infectious and noninfectious processes. Septic thrombosis of the cavernous sinuses most commonly follows infections of the middle third of the face due to Staphylococcus aureus. Other antecedent sites of infection include paranasal (usually sphenoid) sinusitis, dental abscess and, less often, otitis media. Fever is a nearly constant finding, but headache may not be prominent. Periorbital edema, chemosis, proptosis, and limitation of extraocular movements (especially lateral gaze) develop in almost all recognized cases. Involvement of the opposite eye frequently appears within two days following the onset of unilateral signs. Although computed tomography may be helpful, magnetic resonance imaging is probably the diagnostic procedure of choice. Treatment includes appropriate antibiotics and, oftentimes, surgical drainage of the primary focus of infection. Less than half of the patients recover completely; the mortality rate is approximately 30%.

Anti-Bacterial Agents↗
PubMed1985

Intracranial hypertension in Behçet's disease: demonstration of sinus occlusion with use of digital subtraction angiography.

We describe two patients with Behçet's disease who had symptomatic intracranial hypertension due to cerebral venous sinus thrombosis. The sinus thrombosis was demonstrated by digital subtraction angiography. In those patients with Behçet's disease who have unexplained headaches, papilledema, and elevated cerebrospinal fluid pressure, venous digital subtraction angiography is an expedient, accurate, and safe procedure for demonstrating intracranial venous thrombosis.

Adolescent↗
PubMed1993

[Venous MR angiography for the primary diagnosis and follow-up of sinus venous thrombosis. The correlation with the clinical picture and DSA].

30 patients clinically suspected of suffering from venous sinus thrombosis were examined by MRT with venous MR angiography (FLASH 2-D). In 8 patients selective arterial angiography was also performed and 5 patients were followed up by MR angiography after an interval of three months. The MRT images and individual MR angiography images were analysed and 3-D reconstruction performed. In 11 patients MR angiography correctly demonstrated venous sinus thrombosis; the most frequently affected were the superior sagittal sinus, the ascending cerebral veins and the transverse sinus. Compared with DSA, magnetic resonance angiography achieved a high degree of accuracy in our patients. It was significantly better in evaluating the basal sinus system whereas thrombosis of individual ascending veins was better shown by DSA. In summary, primary use of MRT and MR angiography is recommended for the diagnosis of venous sinus thrombosis.

Adult↗
PubMedDate not supplied

Acute thrombosis of the intracranial dural sinus: direct thrombolytic treatment.

Acute intracranial dural sinus thrombosis may have severe morbidity or fatal complications without appropriate treatment. Direct dural sinus venography can be performed safely with a soft Tracker catheter to document the fresh thrombus as an adjunct to CT or MR. We are reporting our experience with successful direct urokinase thrombolytic therapy in three cases of superior sagittal sinus and two cases of transverse and sigmoid sinus thrombosis. All five patients have recovered completely without any residual clinical deficit.

Acute Disease↗
PubMed2005

[Septic thrombosis of the cavernous sinus complicated by intracerebral hemorrhage].

A case of septic cavernous sinus thrombosis in 41 year old men is described. One week prior to hospitalisation he had an influenza infection. During influenza nose furunculus, labial herpes and viral left otitis media with facial nerve paresis occurred. Patient manipulated furunculus nasi. On admission to hospital he complained of severe hedeache, left ear pain and left visual loss. He had left orbital cellulitis with immobile eyeball, the left part of the face, neck and throat were swollen. Lumbar puncture showed cerebrospinal fluid containing protein 156 mg/dl, glucose 94 mg/dl, and 5888 polymorphonuclear cells. Cranial CT scan showed left exophatlmos with periorbital swelling, left ethmoid sinusitis, and probable thrombosis of cerebral vessels. Involvement of the right eye appeared after two days. He was treated with high dose of antibiotics, steroids and anticoagulants. After four days in the control cranial CT scan two focus of intracerebral hemorrhage were found in the frontal lobe. We excluded anticoagulants from the therapy. The patients improved slowly and he was discharged after 22 days of hospitalisation with the left abducent and facial nerve paresis.

Adult↗
PubMed2001

[Fatal sinus vein thrombosis in a patient with mixed connective tissue disease and secondary antiphospholipid antibody syndrome].

BACKGROUND: The antiphospholipid (Huges) syndrome is a complication of connective tissue diseases characterized by thromboembolic occlusions of arterial and venous blood vessels. CASE REPORT: At the age of 13, the patient developed connective tissue disease with arthritis and myositis. The course of her disease was characterized by frequent relapses despite immunosuppressive treatment. She developed deep venous thrombosis of her right leg as a manifestation of secondary antiphospholipid antibody syndrome at the age of 15 and was subsequently started on oral anticoagulation therapy. Approximately 10 months later, however, she decided to try alternative medicine and stopped both anticoagulation and immunosuppressive therapy. Only after 4 weeks she developed seizures followed by respiratory arrest with the need for cardiopulmonary resuscitation. Despite intensive care she died 2 days later with the signs of severe cerebral edema causing herniation of the brainstem. Autopsy confirmed the diagnosis of severe edema of the brain as a result of extensive thrombosis of all sinus veins. CONCLUSION: A complete sinus vein thrombosis is a rare manifestation of antiphospholipid antibody syndrome. The lethal thrombosis in this case occurred during a period of reactive hypercoagulability after termination of immunosuppressive and/or anticoagulation therapy. This case report underlines the need for long-term anticoagulation in patients with the antiphospholipid syndrome.

Adolescent↗
PubMedDate not supplied

[Thrombosis of the cavernous sinus].

The authors describe a case of cavernous sinus thrombosis in a female aged 59 years referred to hospital with suspected tumour at the base of the brain. With the present broad use of sulphamides and antibiotics the incidence of septic thrombosis of the cavernous sinus has decreased considerably. In the reported case the infectious focus giving rise to the thrombosis was in the palatine tonsils or in teeth with gangrenous changes. The thrombosis was associated with infarction of the left hemisphere. The correct diagnosis was established after CT of the head.

Anti-Bacterial Agents↗
PubMed1992

Late development of lateral sinus vein thrombosis.

The incidence of lateral sinus vein thrombosis has been reduced by the use of antibiotics, but it is still a major complication of middle ear disease. Patients without active acute or chronic middle ear infection, however, develop this deadly complication. CT scan is helpful in diagnosis, but mostly the final diagnosis is made by surgical exploration. A case of a 23-year-old patient who developed lateral sinus vein thrombosis without an active middle ear disease is presented. The pertinent literature is discussed.

Adult↗