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Results for “SINUS THROMBOSIS”

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PubMed1993

Magnetic resonance angiography: analysis of vascular lesions of the temporal bone and skull base.

Contrast-enhanced, high resolution, computed tomography (CT), along with gadolinium-enhanced magnetic resonance imaging (MRI), provide the skull-base surgeon with essential information for diagnosis and surgical planning. Evaluation of skull-base vasculature has traditionally been performed with angiography. Four-vessel angiography is an invasive procedure that subjects the patient to the potential risks of vascular injury, stroke, renal damage, anaphylaxis, and radiation. The development of gradient-recall echo pulse sequence in MRI provides a means to evaluate the vasculature with a noninvasive, low-risk technique. We review the experience of the House Ear Clinic with magnetic resonance angiography (MRA) in evaluating cranial-base abnormalities including paragangliomas, aberrant vessels, and dural sinus thrombosis. Based on a review of 25 cases, we conclude that MRA is a useful procedure for evaluation of major arteries, veins, and dural sinuses. The technique has been less helpful in defining small vessel detail such as feeding blood supply and tumor staining.

Carotid Arteries↗
PubMed2006

Idiopathic hypereosinophilic syndrome complicated by central sinovenous thrombosis.

Idiopathic hypereosinophilic syndrome (IHES) is a rare disorder affecting cardiac, pulmonary and nervous systems with peripheral neuropathy, encephalopathy and cerebral thromboembolism. We report a 7-year-old boy with IHES who developed central sinovenous thrombosis and cerebral hemorrhage. Although he had hypereosinophilia for more than 6 months, he was asymptomatic until the sudden onset of vomiting and headache due to superior sagittal sinus thrombosis. Molecular analysis in peripheral blood did not reveal any mutation in the Fip1-like-platelet-derived growth factor receptor alpha chain (FIP1L1-PDGFRA) gene which was recently reported to be mutated in IHES. Since there must be symptoms or signs of organ involvement to fulfill the IHES criteria, we could not make a diagnosis of IHES until the onset of central nervous system involvement. We suggest that anti-coagulant therapy should be considered for asymptomatic patients with hypereosinophilia because hypereosinophilia may induce thrombosis in various organs.

Anticoagulants↗
PubMed1992

Pseudotumor cerebri from cranial venous obstruction.

Dural sinus hypertension from cerebral venous outflow impairment is a cause of pseudotumor cerebri. The authors documented six such patients: two with unilateral neck dissection, one with surgical ligation of the dominant sigmoid sinus, two with thrombosed central intravenous catheterization, and one with dural sinus thrombosis. The site of cerebral venous outflow obstruction was variable and identified in three patients with computed tomography, conventional magnetic resonance imaging, magnetic resonance angiography, and/or angiography. Magnetic resonance angiography used in two patients characterized the venous flow pattern and identified the site of obstruction, confirming magnetic resonance angiography as an effective noninvasive blood flow technique in diagnosing and following these patients. Three patients were treated successfully with medical therapy and one patient with optic nerve fenestration. The two patients with thrombosed central venous catheters had serious systemic illnesses and suffered permanent visual loss.

Adult↗
PubMed2001

Dizziness when eating: an unusual isolated presentation of cerebral venous thrombosis.

A previously healthy 60-year-old man had a two-year history of dizziness or faintness when eating but not when drinking. MRI of the brain detected deep venous dilatation, and digital subtraction cerebral angiography showed superior sagittal sinus thrombosis. These symptoms were completely resolved after the daily administration of 200 mg ticlopidine for four weeks. The pathomechanism of this unusual presentation is speculated episodic congestion of the jugular venous drainage during mealtime due to an increase in the circulatory volume of the external carotid-jugular system.

Angiography, Digital Subtraction↗
PubMed1989

[Evolution of venous cerebral infarction and brain edema--an experimental study of sagittal sinus obstruction].

Superior sagittal sinus with/without neighboring venous system of 36 mongrel cats were occluded by cyanoacrylate polymer after i.v. administration of Evans-blue (EB). Thereafter, the cats were sacrificed 1, 3, 6, 12, 24, 72 or 120 hours after sinus-vein occlusion. According to the degree of occluded region, the cats were divided into two groups; group A (GA) and B (GB). GA showed only superior sagittal sinus occlusion, while many cortical veins were also occluded in GB. No EB nor histological changes were found in 13 cats of GA and 4 sham operated cats, while EB distribution was observed in all 20 cats of GB. The other 3 cats of GA showed a little EB in gyrus lateralis. EB distribution of GB were divided into two types. Type 1 showed EB mainly in the cortical gray matter, while type 2 showed massive EB extravasation in the white matter as well. Edematous changes with gliosis in its resolution phase, were observed in type 1. In addition, EB free zone was formed along with U-fiber zone (cortico-medullary junction) in the cats of later phase (72 hours after occlusion). The findings of EB extension in the type 1 means the existence of blockage against edema evolution from cortex toward subcortical white matter. The cats of type 2 showed fulminant hemorrhagic changes which appeared depend on time interval. Although occurrence of pathological changes were rather earlier than that of cases of clinical cerebral sinus thrombosis, this pathological findings demonstrated the typical character of venous hemorrhagic infarction. In this paper, the similarity and difference between this model and clinical case of sinus-vein thrombosis were discussed. And the possible function of the U-fiber zone in the corticomedullary junction against edema evolution was suggested.

Animals↗
PubMed2003

[Sphenoid sinusitis].

Sphenoid sinusitis is uncommon, with an incidence of about 2.7%. Failure to diagnose and treat sphenoid sinus disease has been shown to lead to serious neurologic sequellae. Plain radiographs play a limited role in the management of sinusitis. CT scan can provide a positive diagnosis by the visualization of mucosal thickening, air-fluid level and complete opacification of the sinusal cavities. In addition, CT can provide more information about the anatomy and abnormalities of the sphenoid sinus. MRI is used in cases of suspected tumors or neurologic involvement. The most common presenting symptom is headache that arise characteristically, but rarely, from the vertex. Sphenoiditis has a high risk of severe neurologic involvement, cavernous sinus thrombosis being one of the most serious complications.

Cavernous Sinus Thrombosis↗
PubMed1995

[The usage of light density heparin (fraxiparin) in the treatment of orbital phlegmonous cellulitis with orbital veins and thrombophlebitis of the cavernous sinus].

A case of 72 years old man, diabetic, suffering from phlegmonous cellulitis with orbital veins and sinus cavernous thrombophlebitis as a nasal vestibule furuncle complication is presented. Apart from the application of antibiotics and surgical procedure, the patient was treated from beginning with thrombolytics specimen, fraxiparine. The methods of treatment of cavernous sinus thrombosis with thrombolytic specimens evoke in the literature controversial opinions. In the author's opinion the early application of fraxiparine in presented case could be regarded as responsible for stopping the process orbital veins and sinus cavernous thrombosis and even causing it to recess. The complete cure without complications (e.g. blindness) is attributed by the authors to the anticoagulation treatment. The authors also stress that fraxiparine may by used for treatment of cavernous sinus thrombophlebitis even when the surgical procedure is planned.

Aged↗
PubMed1990

Pyridoxine-unresponsive homocystinuria with an unusual clinical course.

Progressive premature atherosclerosis and associated thromboembolic complications are the main causes of morbidity and mortality in patients with homocystinuria. However, thrombosis is rarely the predominant or presenting manifestation leading to the diagnosis of homocystinuria. We report on an otherwise asymptomatic teenage boy of normal intelligence who had a superior sagittal sinus thrombosis documented by CT and MRI scans. He presented with pneumothoraces, papilledema, and transient right hemiparesis. He subsequently developed empyema and necrotizing pneumonia as well as deep venous thromboses. The diagnosis of pyridoxine-unresponsive homocystinuria was made on the basis of clinical chemistry analyses, enzyme assay, and clinical trial. He has remained symptom-free under treatment with betaine and methionine restriction. We suggest that there exists a subset of patients with pyridoxine-unresponsive homocystinuria who are at risk for thromboembolism, but who may remain undiagnosed because of an otherwise mild clinical course.

Adolescent↗
PubMed2000

Complications of acute sinusitis in children.

Acute sinusitis is often a mild, self-limiting disease. However, in some cases, especially among children, sinusitis may become a severe, even life-threatening, disease. To examine the nature of complications of acute sinusitis, we studied the cases of children treated at the Helsinki University ENT Hospital, because of a complication caused by acute sinusitis from January 1997 to September 1998. There were 12 children (4 girls, 8 boys), whose ages ranged from 16 months to 16 years. One child had an epidural abscess, one got meningitis and cavernous sinus thrombosis, five had orbital cellulitis, one of whom lost her vision permanently in one eye, and five had preseptal cellulitis. All the children were treated with intravenous antibiotics and all, except the youngest, were treated with a direct sinus puncture. An operation (intranasal antrostomy, orbital drainage, functional endoscopic sinus surgery or adenoidectomy) was performed on six patients. In the majority of children, acute sinusitis is a mild self-limiting disease. However, severe complications still exist. When a complication of sinusitis is suspected, it is of utmost importance that the child be sent immediately to a hospital for proper diagnosis and treatment.

Acute Disease↗
PubMed2002

[Cerebral venous thrombosis and Behcet's disease].

Behcet's disease is a chronic relapsing multisystem disorder of unknown etiology. Neurological complications are frequent, occurring in 10 to 49% of cases. We report 4 cases with Behcet's disease (3 females and 1 male) who had symptomatic intracranial hypertension due to cerebral venous sinus thrombosis within a mean delay of 2 years. The mean age at onset was 31 years and the mean age on referral was 39.5 years. The predominant manifestation in our series were headache, papilledema, seizures and pyramidal syndromes. CT Scan showed non specific abnormalities in all of them and the sinus venous thrombosis was confirmed by MRI in 3 cases. The authors emphasize on the importance of MRI with angio MRI for the diagnosis, the outcome and the evaluation of the cerebral venous thrombosis after treatment.

Adult↗
PubMed2005

Bilateral blindness from orbital cellulitis caused by community-acquired methicillin-resistant Staphylococcus aureus.

PURPOSE: To describe bilateral blindness resulting from infection with community-acquired methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Observational case report. METHODS: A 44-year-old man developed proptosis, ptosis, ophthalmoplegia, and no light perception vision after attempting to lance a nasal pustule. A nasal culture grew MRSA. Imaging showed bilateral orbital cellulitis, pansinusitis, and cavernous sinus thrombosis. The right fundus showed severe ischemia, but the left fundus was essentially normal. RESULTS: Despite initiation of appropriate antibiotics early in the course of infection, the patient lost sight in both eyes. Surgical drainage of the paranasal sinuses and use of intravenous corticosteroids and heparin led to the resolution of orbital cellulitis. CONCLUSIONS: MRSA orbital cellulitis can progress to irreversible blindness despite antibiotic treatment. A new, community-acquired clone of this organism has exhibited increased potential for tissue invasion.

Adult↗
PubMed1996

Emergency endovascular treatment of stroke.

The key to treating arterial or venous vascular occlusive process is to remove the occluding thrombus. We review the available thrombolytic agents and their potential benefits and complications. The results of recent clinical trials are discussed along with strategies for treating intracranial arterial occlusion and venous sinus thrombosis.

Adult↗