Venous Sinus Thrombosis

Question 1

What are the risk factors for developing venous sinus thrombosis?

Answer 1

Pro-thrombotic risk factors (85%)
   -Oral contraceptives
   -Pregnancy/puerperium
   -Malignancy
   -Genetic thrombophilia
Head injury
Recent LP
Infection

Question 2

What is the underlying pathology behind venous sinus thrombosis?

Answer 2

Venous infarction –> vascular congestion –> haemorrhagic necrosis

Question 3

What are the two main types of venous sinus thrombosis?

Answer 3

Cortical venous thrombosis

Dural venous sinus thrombosis

Question 4

What are the sx/signs of cortical venous thrombosis?

Answer 4

Headache (may be thunderclap)
Focal signs
Seizures
Fever
Encephalopathy

Question 5

What are the sx/signs of dural venous sinus thrombosis?

Answer 5

Cavernous sinus thrombosis
   -ocular pain
   -proptosis/chemosis
   -opthalmoplegia
   -papilloedema
   -fever
Sagittal/lateral sinus thrombosis
  -signs of raised ICP (headache, vomiting, fever, papilloedema, seizures)

Question 6

What investigation is appropriate in suspected venous sinus thrombosis?

Answer 6

CT (normal)
LP (raised ICP)
MRI angiography