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At least 217 records · Page 12Linked to original sources
PubMed1996

Behcet's disease: presentation with sagittal sinus thrombosis diagnosed noninvasively.

The standard evaluation of patients with intracranial hypertension frequently does not reveal a discrete pathophysiologic process, leading in these cases to classification of the syndrome as "benign." We present a 35-year-old woman with a recent diagnosis of pseudotumor cerebri who presented with headache, emesis, and blurring of vision. Her symptoms were progressive despite two lumbar punctures that revealed normal cerebrospinal fluid under high pressure. Contrast and noncontrast CT scans were normal; both the cerebrospinal fluid and CT neuroimaging were thus consistent with benign intracranial hypertension. An MRI, however, supported the presence of sagittal sinus thrombosis, a finding which was confirmed by MR venography. Further workup for an underlying cause of sinus thrombosis disclosed symptoms and signs fulfilling the diagnostic criteria for Behcet's disease. Cerebral venous (or sinus) thrombosis should be considered in the differential diagnosis of intracranial hypertension. Behcet's disease, while extremely rare, should be considered as a potential cause of cerebral venous thrombosis. Magnetic resonance venography can serve as a useful diagnostic study in situations where confirmation or exclusion of sinus thrombosis is required.

Acute Disease↗
PubMed1979

Nonmetastatic superior sagittal sinus thrombosis complicating systemic cancer.

Seven patients with cancer complicated by nonmetastatic sagittal sinus thrombosis were encountered in a 7-year period. Five had hematologic malignancies and two had solid tumors. There were two different presentations. In the first, neurologic signs and symptoms (e.g., headaches, seizures, hemiparesis, lethargy) occurred suddenly in five patients shortly after initiation of cancer therapy. Four of these five patients recovered with minimal residua; the fifth died as a direct result of the sinus thrombosis. The second presentation occurred in the two patients with terminal cancer who declined gradually without focal signs; both patients died. Only arteriography can reliably establish the diagnosis of sagittal sinus occlusion. In patients with cancer, sagittal sinus occlusion probably results from a "hypercoagulable state" associated with the systemic neoplasm.

Adenocarcinoma↗
PubMed2003

Latent cerebral venous and sinus thrombosis.

The incidence of cerebral venous and sinus thrombosis (CVST) is still unknown. Several assumptions of the incidence have been made. In the one and only series of consecutive brain autopsies series by Towbin in 1973 CVST was found in 10,9 % of patients aged 60 years or more. These findings suggest that the true incidence of CVST is higher than generally thought, but there are no other reports supporting these findings. Therefore in order to determine the incidence of latent CVST we conducted a new prospective post mortem study. All brain autopsies performed in our hospital between 1996 and 1998 on patients 60 years of age or older were examined for the presence of CVST in a prospective way. We examined the sagittal sinus, the torcula, the straight sinus, both transverse sinuses, and both sigmoideal sinuses for the presence of thrombosis. The clinical condition, medication, brain-imaging results, clinical cause of death, general findings from the body autopsy and definite cause of death were recorded. Additionally we requested the annual mortality figures of CVST at the department of the National Agency for Statistics of the Netherlands (CBS). A consecutive and prospective series of 102 brain autopsies was performed in our general hospital during a period of two years. We found one case of latent CVST in our series of 102 patients. Comparison with the findings of Towbin using a chi-square test yielded a significant difference in the incidence of latent CVST (chi(2) = 7.65, p < 0.01) between the two studies. The present autopsy study demonstrates that latent CVST is rare.

Aged↗
PubMedDate not supplied

Dural sinus thrombosis: verification with spin-echo techniques.

Although MR imaging is being used increasingly to detect dural sinus thrombosis, accurate evaluation of images has often been hindered by the presence of artifacts, especially flow-related enhancement, that may simulate intraluminal clot. We tried an approach with spin-echo techniques to eliminate flow-induced artifacts and, thus, facilitate the diagnosis of dural sinus thrombosis. In this investigation, a nonselective single-section spin-echo verification method was used as a prototype of this approach. Both patients and an experimental flow phantom were used to test the validity of this concept. Clinically, thrombosis was seen to persist as isointense or highly intense signal in the vascular lumina with the specialized sequence, while flow-related artifacts were replaced by hypointense signal, but not by signal void. These same changes were examined both quantitatively and qualitatively in the flow phantom by using varying velocities of flow. Although our clinical investigation concerns suspected dural sinus thrombosis, the principles of these specialized spin-echo techniques can be applied successfully throughout the head to eliminate certain flow-related artifacts.

Adolescent↗
PubMed1994

Two cases of lateral sinus thrombosis presenting with extracranial head and neck abscesses.

Two cases of lateral sinus thrombosis in fit adults with no previous otological history are presented. One case occurred in association with Bezold's abscess and followed mastoiditis which was masked by previous antibiotic treatment. The other case occurred in association with an occipitoparietal scalp abscess and there was no obvious preceding middle ear infection. The causative bacteria were Streptococcus milleri and a variant Streptococcus intermedius. Lateral sinus thrombosis is discussed.

Abscess↗
PubMed1993

[Sinus thrombosis during CDDP and VP-16 (PE) therapy for suprasellar germ-cell tumor: case report].

A case of sinus thrombosis occurring during combination chemotherapy with CDDP and VP-16 (PE) for a suprasellar germ-cell tumor is presented. A 5-year-old girl developed polyuria, polydipsia and headache in April, 1991 and became unconscious on May 10, 1991, when MRI and CT demonstrated a suprasellar tumor and marked hydrocephalus. After a ventriculo-peritoneal shunt operation, radiotherapy and two courses of PE therapy were carried out. During the second course of PE therapy, diabetes insipidus became quite difficult to control and severe hypovolemic hypernatremia developed. While it was being treated, the patient developed a clonic convulsion of her left extremities and visual disturbance. CT scan demonstrated a right parietal hemorrhagic infarction and IV-DSA suggested thrombosis of the superior sagittal sinus. Laboratory data disclosed DIC. The main cause of sinus thrombosis in this patient was considered severe dehydration. It is also possible that cisplatin and steroid played a role. In addition to these, dysfunction of hypothalamus, which is one of the regulatory centers of the plasma concentration of factor VIII, may have contributed to the acceleration of blood coagulation. This case re-emphasized the importance of preventing dehydration and monitoring the blood coagulation fibrinolytic system during PE therapy in patients with a suprasellar germ-cell tumor accompanied with diabetes insipidus.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1981

Heparin-urokinase treatment in aseptic dural sinus thrombosis.

Five patients affected by aseptic dural sinus thrombosis have been treated with a combination of heparin sodium and urokinase. In all of them, the therapy was followed by complete clinical recovery. Postoperative cerebral angiography showed patency of the involved sinuses in all.

Adolescent↗
PubMed1982

Superior sagittal sinus thrombosis followed by subdural hematoma.

A case of superior sagittal sinus thrombosis followed by a subdrual hematoma is reported. A 33-year-old woman, who presented with serious neurological deficits, made a remarkable recovery with mild residual. She had a thin subdural fluid collection, which eventually developed into a subdural hematoma. After evacuation of the hematoma, she had no neurological deficits. Treatment of cerebral venous and dural sinus thrombosis is discussed.

Adult↗
PubMed1980

Dural venous sinus thrombosis in acute lymphoblastic leukemia.

Three children with acute lymphoblastic leukemia developed sagittal sinus thrombosis. One patient was in peripheral remission. One patient survived. In neither patient who died were the walls of the dural sinuses infiltrated with leukemic cells. Attention is drawn to this potentially treatable cause of central nervous system symptoms in childhood leukemia. Angiography is the diagnostic test of choice and can also demonstrate intracerebral hematoma and subdural hematoma, if present. Sinus thrombosis can occur either during exacerbation or remission of the basic leukemic process. The possibility that chemotherapeutic techniques predispose toward this complication is raised.

Adolescent↗
PubMed1994

Transcranial Doppler ultrasound findings in cerebral venous sinus thrombosis. Case report.

Transcranial Doppler ultrasound (TCD) findings are described in a patient with acute thrombosis of the sagittal venous sinus. The TCD finding of prominent venous signals adjacent to the middle cerebral artery gave the first indication of the diagnosis, which was subsequently confirmed by computerized tomography. Awareness of the possible TCD findings in patients with a similar history may lead to a more rapid diagnosis of cerebral venous sinus thrombosis.

Female↗
PubMed2001

Cavernous sinus thrombosis caused by zygomycosis after unrelated bone marrow transplantation.

Invasive zygomycosis is a devastating fungal infection occurring as an opportunistic infection after bone marrow transplantation (BMT). Sinusitis can lead to fungal infection in immunosuppressed patients, and cavernous sinus thrombosis, an uncommon condition in immunocompetent patients, typically follows an infection involving the medial third of the face, nose, or paranasal sinuses. Patients undergoing unrelated-donor BMT (UD-BMT) are prone to develop life-threatening infections because of poor recovery of cellular immunity. Despite adequate clinical evaluation and treatment, the prognosis of patients with invasive fungal infections is dismal, especially when intracerebral structures are affected. We describe a case of a patient who underwent an UD-BMT and developed cavernous sinus thrombosis after sinusitis due to zygomycosis. Moreover, he also had disseminated fungal (Zygomycetes and Aspergillus) and viral (cytomegalovirus and adenovirus) infections.

Adult↗
PubMed2002

Cavernous sinus thrombosis and air embolism following surgery for acoustic neurinoma: a case report.

A 55 year old male patient was operated on for a massive and vascular acoustic neurinoma in a sitting position. The tumor was completely excised. Post-operatively, the patient developed irritability and clinical features suggestive of contralateral cavernous sinus thrombosis. CT scan showed air within the dural walls of the cavernous sinus on the side of surgery. However, there was no radiological evidence of cavernous sinus thrombosis on the contralateral side. Cavernous sinus thrombosis as a post-surgery complication has not been reported. Air within the dural confines of the cavernous sinus has also not been observed or radiologically recorded in the literature.

Cavernous Sinus↗
PubMed2004

[A case of superior sagittal sinus thrombosis after closed head injury].

Superior sagittal sinus thrombosis (SSST) is a rare entity, most often arising from infections, dehydration, and hematologic disorders. Development of this condition secondary to trauma is extremely rare. In this report, a 13-year-old boy who developed SSST following a closed head injury is presented. Imaging studies showed SSST caused by a depressed skull fracture. Neurologic examination of the patient was normal other than bilateral papillary stasis. He was treated with antiedematous and anticonvulsant drugs. Magnetic resonance venography obtained eight months after the diagnosis showed unoccluded superior sagittal sinus, neurologic examination findings were normal, as well.

Adolescent↗
PubMed1991

Cavernous sinus thrombosis following odontogenic and cervicofacial infection.

Cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of infectious processes since the discovery of penicillin. At the present time, dental abscess is an uncommon cause of CST. We now report our experiences with a 60-year-old diabetic male, who developed CST 38 days after extraction of an infected upper third molar tooth. The importance of eradicating regional cervicofacial foci of infection is stressed.

Cavernous Sinus↗
PubMed1990

Lateral sinus thrombosis: a problem still with us.

Lateral sinus thrombosis is now a rare complication of ear disease in the developed world, since the advent of the widespread use of antibiotics. The classic picture is often modified by previous antibiotic treatment making diagnosis and management difficult. Lack of familiarity with this condition amongst present day otologists may lead to late diagnosis and treatment. We review three cases that we have managed recently and compare their clinical courses with the classic description of the disease.

Anti-Bacterial Agents↗
PubMed1988

Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension.

Two cases of complete sagittal sinus occlusion with multiple brain hemorrhages, elevated intracranial pressure, and disseminated intravascular coagulation are described. These patients were successfully managed using pentobarbital-induced coma to ameliorate intracranial pressure elevation. This therapy was combined with monitoring of intracranial pressure and intermittent drainage of cerebrospinal fluid to further control intracranial pressure elevations. Thrombus and coagulopathy resolved with pentobarbital alone in one patient and after pentobarbital plus heparin therapy in the second patient. It is suggested that cases of severe distal sagittal sinus thrombosis with brain hemorrhage and intracranial hypertension may benefit from combined pentobarbital coma and intraventricular drainage. This allows for stabilization of bleeding tendencies before instituting heparin therapy when necessary. Management of sagittal sinus thrombosis with barbiturates or ventricular drainage is best performed in an intensive care unit environment with continuous monitoring of intracranial pressure and substantial electrophysiologic and neuroradiologic support.

Adult↗
PubMed1998

Sagittal sinus thrombosis after closed head injury.

Superior sagittal sinus thrombosis (SSST) is an unusual disorder, most often attributed to hematological abnormalities, oral contraceptive use, or association with the puerperium. Although SSST secondary to trauma has been reported, it still remains an extremely rare entity. Antemortem diagnosis of SSST is made by findings on computed tomographic scanning, cerebral angiography, or magnetic resonance imaging. Prognosis is variable and spontaneous resolution has been reported. Successful treatment options of spontaneous cases include systemic anticoagulation and thrombolytic therapy along with supportive measures. There are currently no guidelines for the management of SSST associated with traumatic brain injury. This report describes a case of SSST in a man who sustained a closed head injury.

Adult↗