Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences.
Adult ; Hemorrhage ; Humans ; Infarction ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus* ; Thrombectomy* ; Thrombosis*

A 33-year-old male was admitted with severe headache lasting 3 days. He did not have a focal neurologic deficit, but had a high intracranial pressure of 512 mmH2O. Cerebral angiography revealed venous sinus thrombosis that mainly involved the superior sagittal and right transverse sinuses. His headache remained severe after intravenous heparin infusion, and so interventional procedures were performed. Mechanical aspiration with the Penumbra system(TM) and other interventional procedures reopened the outflow of the superior sagittal sinus and effectively ameliorated this patient's headache.
Adult ; Cerebral Angiography ; Headache ; Heparin ; Humans ; Intracranial Pressure ; Male ; Neurologic Manifestations ; Sagittal Sinus Thrombosis ; Sinus Thrombosis, Intracranial ; Suction ; Superior Sagittal Sinus ; Thrombectomy ; Thrombolytic Therapy ; Transverse Sinuses ; Venous Thrombosis

We report superior sagittal sinus thrombosis as a central nervous system presentation of Behcet's disease in a patient with peripheral vascular and enteric involvement. The main symptoms were headache and horizontal diplopia due to intracranial hypertension. T1-weighted MRI with gadolinium enhancement revealed a similar pattern of the "empty delta sign" that is usually seen on brain CT. A magnetic resonance venogram revealed filling defects resulting from the thrombosis. These features are helpful for the noninvasive diagnosis of sagittal sinus thrombosis.
Brain ; Central Nervous System ; Diplopia ; Gadolinium ; Headache ; Humans ; Intracranial Hypertension ; Magnetic Resonance Spectroscopy ; Sagittal Sinus Thrombosis ; Superior Sagittal Sinus ; Thrombosis

Cerebral Venous Sinus Thrombosis (CVST) in children is rare and its cause is multifactorial. The clinical manifestations of CVST vary and may cause long-term neurological sequelae and even death on rare occasion. In this case, a 15 year old boy presented with severe headache and vomiting for 1 day. Brain MRI with venography revealed multiple lesions of CVST in superior sagittal sinus and the left transverse sinus. Anticoagulation therapy was performed for 3 months, which led to the complete resolution in superior sagittal sinus and partial resolution in left transverse sinus.
Adolescent ; Brain ; Child ; Headache ; Humans ; Phlebography ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus ; Vomiting

PURPOSE: Knowledge of variations in the cerebral dural venous sinus anatomy seen on magnetic resonance (MR) venography is essential to avoid over-diagnosis of cerebral venous sinus thrombosis (CVST). Very limited data is available on gender difference of the cerebral dural venous sinus anatomy variations. MATERIALS AND METHODS: A retrospective study was conducted to study the normal anatomy of the intracranial venous system and its normal variation, as depicted by 3D MR venography, in normal adults and any gender-related differences. RESULTS: A total of 1654 patients (582 men, 1072 women, age range 19 to 86 years, mean age: 37.98±13.83 years) were included in the study. Most common indication for MR venography was headache (75.4%). Hypoplastic left transverse sinus was the most common anatomical variation in 352 (21.3%) patients. Left transverse sinus was hypoplastic in more commonly in male in comparison to female (24.9% versus 19.3%, p = 0.009). Most common variation of superior sagittal sinus (SSS) was atresia of anterior one third SSS (15, 0.9%). Except hypoplastic left transverse sinus, rest of anatomical variations of the transverse and other sinuses were not significantly differ among both genders. CONCLUSION: Hypoplastic left transverse sinus is the most common anatomical variation and more common in male compared to female in the present study. Other anatomical variations of dural venous sinuses are not significantly differ among both genders.
Adult ; Female ; Headache ; Humans ; Male ; Phlebography* ; Retrospective Studies ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus

We present a case of extensive thrombosis in the jugular vein and sigmoid, transverse, superior sagittal sinuses with partial deep venous thrombosis. The patient had acute severe headache but had neither focal neurological deficit nor consciousness change. Emergency endovascular thrombolysis through transfemoral approach was performed with successful restoration of venous drainage. There was no hemorrhagic complication. Several days later, the patient had a focal seizure attack due to focal venous infarction despite of continuous systemic anticoagulation therapy.
Colon, Sigmoid ; Consciousness ; Drainage ; Emergencies ; Headache ; Humans ; Infarction ; Jugular Veins ; Seizures ; Sinus Thrombosis, Intracranial* ; Superior Sagittal Sinus ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis

We experienced a case of giant arachnoid granulation misdiagnosed as dural sinus thrombosis. A 66-year-old woman presented with a one month history of progressive occipital headache. Computed tomography angiography and cerebral angiography showed a round filling defect at the transverse sinus which was speculated as a transverse sinus thrombosis. Anticoagulation therapy was performed to prevent worsening of thrombosis for 2 weeks and then a Gadolinium-enhanced magnetic resonance imaging scan was performed. The filling defect lesion at the transverse sinus revealed a non-enhancing granule with central linear enhancement, which was compatible with giant arachnoid granulation. We checked the intrasinus pressure difference across the lesion the through the dural sinus in order to exclude the lesion as the cause of headache. Normal venous pressure with no significant differential pressure across the lesion was noted. Headache was treated with medical therapy.
Aged ; Angiography ; Arachnoid ; Cerebral Angiography ; Female ; Headache ; Humans ; Lateral Sinus Thrombosis ; Magnetic Resonance Imaging ; Sinus Thrombosis, Intracranial ; Thrombosis ; Venous Pressure

Thrombosis of venous channels in the brain is not a common cause of cerebral infarction relative to arterial disease but is an important consideration because of its variable clinical features and potential morbidity. It is very often unrecognized at initial presentation. The diagnostic modality is brain imaging with magnetic resonance venography. An empty-delta sign appears on a contrast CT scan as enhancement of the collateral vein in the superior sagittal sinus wall surrounding a nonenhanced thrombus in the sinus. However, the sign is frequently absent. Heparin should be considered in the management of cerebral venous sinus thrombosis (CVST). We report a case of CVST in a 59-year-old woman that presented initially as a headache and was diagnosed after several visits to clinics.
Brain ; Cerebral Infarction ; Female ; Headache ; Heparin ; Humans ; Middle Aged ; Neuroimaging ; Phlebography ; Sinus Thrombosis, Intracranial* ; Superior Sagittal Sinus ; Thrombosis ; Tomography, X-Ray Computed ; Veins

No abstract available.
Polycythemia* ; Sinus Thrombosis, Intracranial*

Cerebral venous sinus thrombosis (CVST) may be complicated with various intracranial hemorrhage such as petechial hemorrhage, hemorrhagic infarction, parenchymal hemorrhage, subarachnoid hemorrhage (SAH), and subdural hematoma (SDH). However, combination of these types of intracranial hemorrhages supervening on CVST is seldom reported. A 55-year-old female with rectal cancer presented with severe headache, nausea, vomiting and diplopia. She was diagnosed as having CVST in the superior sagittal sinus with left frontal parenchymal hemorrhage and was treated with anticoagulants. The CVST were extended to inferior sagittal and straight sinuses. Moreover, SDH along the left cerebral convexity and SAH in the left sylvian fissure were simultaneously observed. Our present case shows that combination of various types of hemorrhages is rare but may occur in advanced CVST.
Anticoagulants ; Diplopia ; Female ; Headache ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages ; Nausea ; Rectal Neoplasms ; Sinus Thrombosis, Intracranial ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus ; Vomiting