Daily Bolus of LR: Cerebral venous thrombosis

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November 8, 2012 by dailybolusoflr

Courtesy of Dr. Caitlin McCord
Cerebral (or dural sinus) venous thrombosis
·         The major dural sinuses are:
o   Superior sagital sinus
o   Inferior sagital sinus
o   Straight sinus
o   Lateral sinuses
o   Sigmoid sinuses
·         Triad = headache + papilledema + high opening pressure (clearly NOT seen in everyone!)
·         Symptoms can be indolent and average time to presentation in some studies is 7 days
·         Can cause seizures (usually partial) in up to 40% of cases
·         Presentation can mirror pseudotumor cerebri, so consider MRI/MRV (gold standard for diagnosis) in with risk factors:
o   Thrombophilia
o   Nephrotic syndrome
o   Chronic inflammatory disease
o   Pregnancy/OCPs
o   Meningitis/mastoiditis/sinusitis
o   Direct trauma to venous sinuses, or medical procedures to the head/neck area. 
Ref: Rosen’s Emergency Medicine, 7th ed

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