Transverse Sinus Thrombosis: An Unusual Cause of Headache

Wasson, James R.; Redenbaugh, James

doi:10.1046/j.1526-4610.1997.3707457.x

Cited by 16 publications

(10 citation statements)

References 14 publications

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“…Unilateral lateral sinus thrombosis, either alone or associated with jugular vein occlusion, was seen in seven patients; this tendency of lateral sinus thrombosis to present solely with headache was observed in other studies [3, 4, 7]. Nonetheless, we had not found a statistically significant association between characteristics of headache or associated symptoms and signs (in those patients from the initial series of CVT that presented with a distinct clinical picture) and extension of CVT or involved sinuses.…”

Section: Discussionsupporting

confidence: 48%

Headache as the sole presentation of cerebral venous thrombosis: a prospective study

et al. 2012

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Headache is the most frequent presenting symptom of cerebral venous thrombosis (CVT), most commonly associated with other manifestations. It has been described as its only clinical presentation in 15 % of patients. There is no typical pattern of headache in CVT. The objective of this study was to study the characteristics of headache as the sole manifestation of CVT. From a prospective study of 30 consecutive patients diagnosed with CVT over 18 months, we selected those who presented with headache only: they had a normal neurological examination, no papilloedema and no blood or any parenchymal lesion on CT scan. All were submitted to a systematic etiological workup and a structured questionnaire about the characteristics of headache was provided. Headache was the sole manifestation of CVT in 12 patients; it was diffuse or bilateral in the majority. Seven patients referred worsening with sleep/lying down, Valsalva maneuvers or straining. There was no association between the characteristics of headache and extension of CVT. Time from onset to diagnosis was significantly delayed in these patients presenting only with headache. In our series, 40 % of patients presented only with headache. There was no uniform pattern of headache apart from being bilateral. There was a significant delay of diagnosis in these patients. Some characteristics of headache should raise the suspicion of CVT: recent persistent headache, thunderclap headache or pain worsening with straining, sleep/lying down or Valsalva maneuvers even in the absence of papilloedema or focal signs.

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Section: Discussionsupporting

confidence: 48%

Headache as the sole presentation of cerebral venous thrombosis: a prospective study

et al. 2012

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“…Headache as the only presentation of CVT in the absence of such conditions is rare. [5][6][7][8] In this paper we present the characteristics of 17 patientsfrom a prospective series of 123 patients with CVT seen over four years at our institution-in whom headache was the only clinical presentation of CVT in the absence of intracranial hypertension, SAH, meningitis, or other intracranial lesion as assessed by head CT and/or CSF examination.…”

mentioning

confidence: 99%

Headache as the only neurological sign of cerebral venous thrombosis: a series of 17 cases

Cumurciuc

Crassard²,

Sarov³

et al. 2005

Journal of Neurology, Neurosurgery & Psychiatry

266

180

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Background: Headache is the most frequent symptom in cerebral venous thrombosis (CVT), and usually the first. However, it has rarely been reported as the only symptom of CVT. Objectives: To study the characteristics of patients in whom headache was the only presentation of CVT in the absence of intracranial hypertension, subarachnoid haemorrhage (SAH), meningitis, or other intracranial lesion. Methods: From a prospective study of 123 consecutive patients with CVT only those with isolated headache and normal brain computed tomography (CT) scan and cerebrospinal fluid (CSF) examination were included in the present study. All patients underwent an extensive systematic aetiological work-up and were given intravenous heparin followed by oral anticoagulants. A detailed description of the headache was obtained. Results: Headache was only sign of CVT in 17 patients. The lateral sinus was the most frequently involved sinus (n = 15). Onset of headache was progressive in 11, acute in 3, and thunderclap in 3 patients. Once established, the headache was continuous in 15, diffuse in four and unilateral in 13, usually ipsilateral to the occluded lateral sinus. No specific risk factor or cause was found. All had a favourable evolution. Conclusion: The pathogenesis of isolated headache in CVT in the absence of intracranial hypertension, SAH, meningitis or intracerebral lesion is unknown but may involve changes in the walls of the occluded sinus. Hence MRI/MRV should be used to look for signs of CVT in all patients with recent headache (progressive or thunderclap) even when the CT scan and CSF examination are normal.

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“…Cardiac diseases, such as congenital heart failure, cardiac insufficiency and pace maker use, may be also associated with CVT. CVT can be also caused by cirrhosis, Crohn's disease and ulcerative colitis [1,8].…”

Section: Discussionmentioning

confidence: 99%