[Non-infectious thrombosis of the cerebral venous sinuses and veins in adults. A report of five cases].

INTRODUCTION

Thrombosis of the veins and venous sinuses is an uncommon condition. In 1947 it was described in adults by Garcin and Pestel. It is a potentially serious disorder, in which there is severe intracranial hypertension which may be fatal or cause serious neurological sequelae. Diagnosis is made, during life, on the clinical condition and neuro-imaging features. We consider that treatment of the underlying condition is essential to improve prognosis, although this is controversial. In Cuba there are no publications reporting series of patients with this condition.

CLINICAL CASES

We present five patients, four of whom were women, with a neurological disorder involving focal neurological deficits, headache and severe intracranial hypertension, of subacute onset and with convulsions in 60%. The results of imaging studies were compatible with thrombosis of veins and/or venous sinuses. The diagnosis was conformed at necropsy in two patients. The commonest risk factor was the puerperium, occurring in four cases. The patients were treated symptomatically. Two patients died. The other patients made good progress.

CONCLUSIONS

The puerperium is the commonest risk factor in thrombosis of the venous sinuses and the veins draining into them. Headache, neurological focal signs and level of consciousness are the main symptoms and signs. Coma, haemorrhagic infarct and convulsions are of bad prognosis and followed by unsatisfactory progress of the disorder.