Clinical Features of Cortical Venous and Dural Sinus Thrombosis

In this article, we will discuss the Clinical Features of Cortical Venous and Dural Sinus Thrombosis. So, let’s get started.

Clinical Features

Cerebral venous occlusion causes an increase in intracranial pressure and local ischemia/infection which is often hemorrhagic the clinical features are divided into:

(1) Features of sepsis: Thrombophlebitis of cortical vein or septic thrombosis of dural sinus produces fever, generalized pain, nausea, vomiting and prostration in addition to the localised signs.

(2) Features due to cortical vein thrombosis: These are focal features depending on the area involved. These include focal cortical deficits (aphasia, hemiplegia etc.) and seizures (focal for generalized). The deficit may increase if spreading thrombophlebitis occurs.

(3) Features of cerebral venous sinus thrombosis: The clinical features depend on the Dural sinus involved and is given below:

Cavernous sinus thrombosis: Features involve chemosis, proptosis, ptosis, headache, ophthalmoplegia (internal and external), papilledema, retinal hemorrhage and reduced sensation in the trigeminal first division. 3rd, 4th and 6th cranial nerves palsy. Involvement is often bilateral and patient is ill with fever, headache, retro-orbital pain and toxemia.

Superior sagittal sinus: Headache, papilledema, seizures, coma. May involve veins of both hemisphere producing weakness of both legs (paraplegia) or quadriplegia with predominant lower limbs involvement and sensory focal deficits. Fever, neck stiffness or signs of meningitis if associated with bacterial meningitis.

Transverse sinus 6th: Headache, otalgia, hemiparesis, convulsions, papilledema, Gradinego’s syndrome (retro-orbital or facial pain, otitis media and 6th cranial Nerve palsy)

Jugular foramen or jugular vein: Commonly transverse sinus thrombosis spreads to jugular vein; hence its features may be present. 9th 10th and 11th cranial nerve palsies.

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