Satoh H, Uozumi T, Kiya K, Arita K, Kurisu K, Sumida M, Ikawa F
Department of Neurosurgery, Hiroshima University School of Medicine.
No Shinkei Geka. 1993 Oct;21(10):953-7.
Although sinus thrombosis occurs owing to various causes, sinus thrombosis after closed head injury is rarely reported. The authors encountered 2 cases with sinus thrombosis in whom intracranial hypertension occurred after closed head injury. In case 1, left abducens and oculomotor palsy developed as a false localizing sign, together with symptoms of intracranial hypertension 10 days after head injury. Using angiography, we made a diagnosis of stenosis of the superior sagittal sinus. Since the symptoms were aggravated under conservative treatment, V-P shunt was performed, but impaired vision was not improved. In case 2, symptoms of intracranial hypertension occurred 10 days after head injury. We performed magnetic resonance angiography (MRA) and made a diagnosis of stenosis of the bilateral transverse sinuses. The symptoms improved under conservative treatment. The use of conventional angiography has been the most reliable for a diagnosis of sinus thrombosis, but MRA will become useful from now on. For diagnosis, it is important to suspect sinus thrombosis after closed head injury. Surgical decompression is required for patients in whom symptoms are aggravated under conservative treatment.
