Nonmetastatic superior sagittal sinus thrombosis complicating systemic cancer

Sigsbee, Bruce; Deck, Michael D. F.; Posner, Jerome B.

doi:10.1212/wnl.29.2.139

Cited by 76 publications

(28 citation statements)

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“…The present series reflects our interest in Behcet's disease which was found to be an underrecognised cause of CVT (6/38), possibly because CVT can be the initial manifestation of the disease. 30 " 32 Among other causes found in this series some are frequent and classic ones such as minor head injuries, 33 malignancies, 19 pregnancy and post-partum 15 ' 45 whereas others are quite uncommon: systemic lupus, 34 nephrotic syndrome 35 and antithrombin III deficiency. 36 In 10/38 cases, no cause could be found despite a mean follow up of more than 4 years, corresponding to so called "idiopathic" cases or "primary" CVT.…”

Section: -mentioning

confidence: 84%

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Cerebral venous thrombosis--a review of 38 cases.

Bousser¹,

Chiras²,

Bories³

et al. 1985

Stroke

685

420

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199SUMMARY A series of 38 patients with angiographically proven cerebral venous thrombosis (CVT) affecting dural sinuses is reported. This study shows that CVT is not rare, that the clinical diagnosis is extremely difficult because of the variable modes of onset and groupings of symptoms, that most CT findings are non specific and that angiography remains the best diagnostic tool. Only 4 patients died, which suggests a more benign outcome than classically described. None of the 23 heparin treated patients died, which indicates that anticoagulants were not harmful in this series.

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Section: -mentioning

confidence: 84%

“…14 " 19 To illustrate this evidence, we report a series of 38 patients with angiographically proven CVT affecting dural sinuses.…”

mentioning

confidence: 99%

Cerebral venous thrombosis--a review of 38 cases.

Bousser¹,

Chiras²,

Bories³

et al. 1985

Stroke

685

420

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show abstract

“…However, to date the only randomized placebo-controlled data on heparin treatment in CSVT derive from a study which had to be terminated after an interim analysis of 20 patients because of the significant advantage of heparin [10]. Later on the small number of patients provoked controversy and uncertainty concerning the use of full-dose heparin [27, 28, 29], and the high rate of intracranial hemorrhages in cerebral venous thrombosis sometimes induced neurologists to hesitate administering heparin in effective dosage [27, 28, 29, 30, 31, 32, 33]. …”

Section: Introductionmentioning

confidence: 99%

Heparin Treatment in Acute Cerebral Sinus Venous Thrombosis: A Retrospective Clinical and MR Analysis of 42 Cases

et al. 1998

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The only randomized data on heparin treatment in acute cerebral sinus venous thrombosis (CSVT) are derived from a small number of patients. The rate of intracranial hemorrhages as a complication of high-dose heparin treatment is still unknown. This retrospective study evaluates the clinical features, neuroimaging monitoring and outcome of 42 patients with proven CSVT. Diagnosis was established by DSA, CT, MR tomography and MR angiography. All patients received heparin intravenously guided by doubling the aPTT value for 3 weeks, followed by oral anticoagulation. Partial or complete recanalization was found in 36 cases. 40 patients improved clinically, in 26 of them complete recovery was observed. One patient deteriorated and developed an apallic syndrome, one further patient died of septic multiorgan failure. Only in one patient was hemorrhagic transformation of infarcted brain tissue observed but without clinical deterioration.

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“…Our patients were highly selected and were not representative of the spectrum of DST. [12][13][14][15][16][17] Initial evaluation in some patients with DST suggested BIH, but reassessment and the use of DSA revealed more serious underlying pathology, notably Behcet's syndrome and sarcoma of the occiput. To avoid incorrect diagnosis of BIH, we suggest that all male patients and any female patients lacking the risk factors for BIH [18][19][20] should be screened with DSA and MRI, which has recently been found to be of potential value in diagnosing DST.…”

Section: Discussionmentioning

confidence: 99%

Papilledema without Lateralizing Signs

et al. 1990

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The cases of 40 patients (aged, 18-40 y) who presented with papilledema without lateralizing signs (PWLS) were analyzed retrospectively, with particular reference to the underlying causes. Benign intracranial hypertension and pseudotumor cerebri were the most common causes and dural sinus thrombosis was the next most common. Benign intracranial hypertension was more prevalent among women (25 females versus one male) and dural sinus thrombosis was more prevalent among men (seven males versus two females). Space-occupying lesions were the least common cause. Males presenting with PWLS and females lacking the risk factors for benign intracranial hypertension should undergo digital subtraction angiography and be followed regularly to rule out any underlying structural disorder before a diagnosis of benign intracerebral hypertension can be made.T Obeid, CP Panayiotopoulos, B Yaqub, ARH Shamena, AK Daif, Papilledema Without Lateralizing Signs. 1990; 10(3): 254-257 Papilledema is a swelling of the optic nerve head due to raised intracranial pressure.1 Before the introduction of modern imaging techniques, 60% of patients with intracranial brain tumors were reported to have papilledema, 2 although this figure has decreased to 25% because of earlier diagnosis and better overall management.3 In a review of 238 patients with PWLS published 33 years ago, 4 it was reported that 45% had lateralized mass lesions, 26% had obstructive midline lesions, and only 11% had benign intracranial hypertension (BIH), revealed by air encephalography and surgical exploration. Twenty years later, Weisberg 5 evaluated PWLS in 100 patients and found that the earlier figures had reversed (BIH, 71%; mass lesions, 18%; heterogeneous causes, 11%). We have been unable to find a comparative study done in the context of modern imaging techniques and published since Weisberg's report. Furthermore, BIH may be erroneously diagnosed in patients if they have undergone only computed tomographic (CT) screening but not angiography and if no regular follow-up has been done. The diagnosis of BIH should only be made in patients with raised intracranial pressure, a CT scan demonstrating normal or slit-like ventricles, normal cerebrospinal fluid findings, and the presence of widely associated and recognized risk factors detected after a regular follow-up. MethodsThe cases of 44 adults with papilledema without lateralizing signs (PWLS) retrospectively. There were nine males and 31 females. Patients with lateralizing neurological signs, meningeal irritation, or a history of head trauma were excluded. All patients had been followed for at least 6 months.All patients had routine blood and urine biochemical assessment profiles. They also had had CT brain scans, and lumbar puncture was performed in all but five, four of whom were excluded because they refused the procedure and therefore a definitive diagnosis was not reached. CT scanning demonstrated brain tumors in two patients and a hemorrhagic infarct in a third. Digital subtraction angiography (DSA) was carrie...

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Nonmetastatic superior sagittal sinus thrombosis complicating systemic cancer

Cited by 76 publications

References 0 publications

Cerebral venous thrombosis--a review of 38 cases.

Cerebral venous thrombosis--a review of 38 cases.

Heparin Treatment in Acute Cerebral Sinus Venous Thrombosis: A Retrospective Clinical and MR Analysis of 42 Cases

Papilledema without Lateralizing Signs

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