All locations of intracranial venous thrombosis can cause headache.
Isolated sagittal sinus thrombosis (=nearly half of intracranial venous thrombosis) or lateral sinus thrombosis present with:
- potentially focal neurological signs
Cavernous sinus thrombosis can cause:
- oedematous eyelids
- painful eye movements/opthalmoplegia
Remember: cavernous sinus contains CN III, IV, V1, V2 and VI, plus the internal carotid artery.
Sigmoid sinus thrombosis:
- cerebellar signs
Inferior petrosal sinus thrombosis:
- 5th and 6th nerve palsies
Risk factors for developing intracranial venous thrombosis include:
- head injury
- recent LP
- oral contraceptive pill
- CT may show 'absent delta sign' which implies a filling defect and therefore a thrombosis
Management is by specialists, ?heparin
On to the more familiar topic of infective endocarditis...