Intracranial venous thrombosis

Question 1

Common sites of intracranial venous thrombosis

Answer 1

sagittal sinus thromboses
lateral sinus thromboses cavernous sinus thromboses

Question 2

Clinical features

Answer 2

headache (sudden onset)
nausea & vomiting
reduced consciousness

Question 3

Neuroimaging

Answer 3

MRI venography = gold standard
CT venography = alternative

non-contrast CT head normal in 70%

Question 4

Management of intracranial venous thrombosis

Answer 4

• LMWH
• warfarin for longer term anticoagulation

Question 5

How do sagittal sinus thromboses usually present?

Answer 5

• seizures and hemiplegia

Question 6

Venography finding in sagittal sinus thrombosis

Answer 6

parasagittal biparietal or bifrontal haemorrhagic infarctions

‘empty delta sign’ seen on venography

Question 7

What cranial nerves are affected in lateral sinus thrombosis?

Answer 7

6th and 7th cranial nerve palsies