HIRNVENEN UND SINUSTHROMBOSEN

Abstract

Conspicuous psychiatric symptoms, disturbances in consciousness and changing cerebral focal symptoms can be caused by intracranial thromboses of sinuses and veins. Causal relationships exist particularly with inflammatory processes in the area of the ear, nose and throat; with increased tendency toward blood clotting in recurrent peripheral thromboses during late pregnancy and after delivery; with open and contused craniocerebral trauma of all degrees of severity; and occasionally with decompensating right-heart insufficiency. The course of the process and the clinical symptomatology vary considerably given the different localizations and the spread of the thrombotic process. Under certain circumstances, signs of local complications, such as subarachnoidal hemorrhage, formation of a hematoma of abscess, or systematic symptoms (sepsis, pulmonary embolism) tend to predominate. The diagnosis is confirmed by angiography; radiologic signs are a slower venous phase and the failure to demonstrate individual segments of sinus or veins. In addition to conservative and, under certain circumstances, surgical treatment of the basic disease as well as symptomatic measures, combined anti-edematous, antithrombotic and - when the diagnosis is established early - also fibrinolytic therapy can be instituted.