scholarly journals P.056 Intracranial hemorrhage as initial presentation of sagittal sinus thrombosis: review of 3 cases

2017 ◽  
Vol 44 (S2) ◽  
pp. S27-S27
Author(s):  
JY Chu
Keyword(s):  
Intracranial Hemorrhage ◽  
Cerebral Hemorrhage ◽  
Motor Vehicle ◽  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Transverse Sinus ◽  
Sagittal Sinus ◽  
Oral Warfarin ◽  
Sagittal Sinus Thrombosis ◽  
Ct And Mri

Background: Intracranial hemorrhage due to sagittal sinus thrombosis is an unusal inital clinical presentation and a series of 3 cases is presented. Methods: A retrospective study of stroke patients seen at the William Osler Health System between 2014 -2016. Results: 1: 43 y.o. female presented with headaches and right hemiparesis. CT and MRI/MRV showed L. parietal intra-cerebral hemorrhage and sagittal and transverse sinus thrombosis. She was treated with IV heparin and subsequent oral Warfarin but developed symptomatic left subdural hematoma which was successfully evacuated. Hypercoagulable workup was negative. Subsequent MRI/MRV showed resolution of her sinus thrombosis and received asparin only since. 2: 45 y.o. male presented with generalized seizure 10 days following a motor vehicle accident. Initial CT showed focal right frontal subarachnoid hemorrhage and subsequent MRI/MRV confirmed extensive sagittal sinus thrombosis. He was treated with IV heparin and subsequent Warfarin without any complications. 3: 32 y.o. male presented with generalized seizure. CT and MRI/MRV confirmed a large right temporal lobe intra-cerebral hemorrhage and extensive right transverse sinus and straight sinus thrombosis. He was successfully treated with IV heparin followed by oral Warfarin. Conclusions: Despite intracranial hemorrhage in patients with cerebral sinus venous thrombosis, they could be managed successfully with anticoagulation therapy and with careful clinical and neuro-imaging monitoring.

Management and outcome of spontaneous cerebral venous sinus thrombosis in a 5-year consecutive single-institution cohort

2016 ◽  
Vol 9 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Darrin J Lee ◽  
Arjang Ahmadpour ◽  
Tamar Binyamin ◽  
Brian C Dahlin ◽  
Kiarash Shahlaie ◽  
...  
Keyword(s):  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Venous Sinus Thrombosis ◽  
Sagittal Sinus ◽  
The Impact

BackgroundCerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with a variable presentation, ranging from headaches, to coma and death. Although the American Stroke Association has developed guidelines for the treatment of CVST, data are sparse on the outcome after treatment with anticoagulation, thrombolysis, and thrombectomy.MethodsIn this retrospective review, we describe the 5-year UC Davis experience with spontaneous CVST.ResultsForty-one patients (mean age 37.5±23.1, range 0–96 years; 29 female) were identified with CVST. The majority of cases involved the transverse sinus (75.6%), sigmoid sinus (58.5%), and superior sagittal sinus (29.3%). The most common form of treatment was anticoagulation or antiplatelet therapy (n=35), while six patients were managed by observation alone. The overall 1-year modified Rankin score (mRS) was 1.4±1.5. Male patients and patients with a poor admission mRS had a worse outcome. Outcome was unaffected by hypercoagulable state, number of dural sinuses involved, the presence of intracranial hemorrhage, or seizures. Two patients who underwent anticoagulation therapy also required endovascular thrombectomy; both patients had a 1-year mRS of ≤2. Two patients underwent direct open surgical canalization of the superior sagittal sinus with varying outcomes (mRS 2 vs mRS 6).ConclusionsIn our series, the majority (92.9%) of patients with spontaneous dural sinus thrombosis had a favorable clinical outcome as defined by a mRS ≤2. Further prospective studies are needed to study the impact of anticoagulation on the clinical course of the disease.

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

Stroke ◽  
1988 ◽  
Vol 19 (7) ◽  
pp. 903-909 ◽  
Author(s):  
D F Hanley ◽  
E Feldman ◽  
C O Borel ◽  
A E Rosenbaum ◽  
A L Goldberg
Keyword(s):  
Intracranial Hypertension ◽  
Cerebral Hemorrhage ◽  
Sinus Thrombosis ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis

Periorbital cellulitis, subgaleal abscess and superior sagittal sinus thrombosis: a rare combination of complications arising from unilateral frontal sinusitis

2012 ◽  
Vol 126 (12) ◽  
pp. 1281-1283 ◽  
Author(s):  
H Jones ◽  
A Trinidade ◽  
M C Jaberoo ◽  
M Lyons
Keyword(s):  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Delayed Diagnosis ◽  
Clinical Signs ◽  
Frontal Sinusitis ◽  
Sagittal Sinus ◽  
Rare Combination ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

AbstractBackground:Subclinical infection of the sinuses can result in delayed diagnosis and unusual presenting complications.Case report:This paper describes the case of a 14-year-old boy with a rare combination of periorbital cellulitis, subgaleal abscess and superior sagittal sinus thrombosis following a late presentation of unilateral frontal sinusitis.Results:Following multiple surgical procedures, and antimicrobial and anticoagulation therapy, the patient made a full recovery.Conclusion:Serious sinusitis complications still occur, and can do so in unusual combinations with minimal clinical signs. Systemic anticoagulation therapy is considered safe practice in the management of cerebral venous sinus thrombosis and may reduce morbidity and mortality.

Superior sagittal sinus thrombosis induced by thyrotoxicosis

2001 ◽  
Vol 94 (1) ◽  
pp. 130-132 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Chun-Chung Lui ◽  
Cheng-Loong Liang ◽  
Han-Jung Chen ◽  
Yeh-Lin Kuo ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Venous Blood ◽  
Fibrinogen Concentration ◽  
Venous Blood Flow ◽  
Content Type ◽  
Sagittal Sinus ◽  
Low Protein ◽  
Diffuse Goiter

✓ There is a wide variety of disorders associated with thrombosis of the superior sagittal sinus (SSS), including infectious disease, noninfectious conditions such as vasculitis and hypercoagulable states, and complications arising from pregnancy or use of oral contraceptive medications. Despite these well-defined associations, approximately 25% of the cases remain idiopathic. In this article the authors describe a patient who was found to have SSS thrombosis while experiencing a thyrotoxic phase of Graves disease. The patient presented with intracerebral hemorrhage, subarachnoid hemorrhage, seizure, coma, a raised fibrinogen concentration, low protein C activity, and atrial fibrillations. Thrombolysis was successfully performed despite the coexistence of thrombosis and intracranial hemorrhage. Patients with thyrotoxicosis and a diffuse goiter may be predisposed to the development of SSS thrombosis, as a result of hypercoagulation and stasis of local venous blood flow. In the present case, a patient in whom thrombosis coexisted with intracranial hemorrhage was successfully treated using thrombolytic therapy.

Superior sagittal sinus thrombosis complicating neck dissection

2010 ◽  
Vol 124 (10) ◽  
pp. 1126-1128
Author(s):  
D J Howe ◽  
M J Henderson ◽  
I Ahmad
Keyword(s):  
Neck Dissection ◽  
Internal Jugular Vein ◽  
Superior Sagittal Sinus ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Elective Neck Dissection ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

AbstractObjective:To report a superior sagittal sinus thrombosis occurring as a rare complication of neck dissection, and to present a review of published literature.Case report:A 42-year-old man underwent an elective neck dissection for a tumour stage 2, node stage 2b, tonsillar squamous cell carcinoma, prior to chemoradiotherapy. During surgery, the right internal jugular vein was sacrificed as part of the resection, as tumour was adherent to it. Two weeks after surgery, the patient was readmitted with seizures. Subsequent computed tomography and magnetic resonance venography confirmed a superior sagittal sinus thrombosis. The patient was subsequently anticoagulated and underwent radiotherapy without further complication. A review of pre-operative imaging indicated a dominant internal jugular vein, ligation of which may have been a factor in the subsequent sagittal sinus thrombosis.Conclusion:Superior sagittal sinus thrombosis following neck dissection is a rare occurrence, with little reported in the literature. Dominant internal jugular vein anatomy may be evident on pre-operative imaging. An awareness of this complication may be helpful to surgeons contemplating sacrifice of the internal jugular vein.

Sagittal sinus thrombosis associated with thrombocytopenia: a report of two patients

1999 ◽  
Vol 21 (2) ◽  
pp. 573-575 ◽  
Author(s):  
Gülay Alper ◽  
Su G Berrak ◽  
Gazanfer Ekinci ◽  
Cengiz Canpolat ◽  
Canan Erzen
Keyword(s):  
Sinus Thrombosis ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis
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