Intracranial venous thrombosis (IVT)

Question 1

What happens in an IVT?

Answer 1

Blood clot forms in the brains venous sinuses

Question 2

Name 3 ways IVT can present

Answer 2

• Headache
• Confusion/drowsiness
• Impaired vision
• Nausea/vomiting
• Seizures
• Cranial nerve palsies
• Papilloedema

Question 3

Name 2 causes

Answer 3

• The pill, pregnancy, and the peripartum period
• Prothrombotic haematological conditions,
• Systemic disease i.e. dehydration or sepsis
• Skull abnormalities
• Trauma
• Local infection
• Malignancy

Question 4

1) What is the gold standard investigation?
2) What is the other investigation that can be used?

Answer 4

1) MRI venography
2) CT venography

Question 5

1) How is IVT normally managed acutely?
2) How is it normally managed long term?

Answer 5

1) LMWH
2) Warfarin

Question 6

In a sagittal sinus thrombosis venography, what sign is characteristically seen?

Answer 6

Empty delta sign

Question 7

In a cavernous sinus thrombosis, what cranial nerve is typically damaged first?

Answer 7

6th

Question 8

Lateral sinus palsy results in a palsy of which 2 cranial nerves?

Answer 8

6 and 7