Venous Sinus Thrombosis
- Definition: Thrombophlebitis of the venous sinus.
- Etiology: It usually develops secondary to direct extension.
Clinical Picture
- Signs of blood invasion:
- (Spiking) fever with rigors and chills
- Persistent fever (septicemia)
- Positive Greissinger’s sign: Edema and tenderness over the area of the mastoid emissary vein Z
- Headache, vomiting, and papilledema (increased intracranial pressure)
Diagnosis
- CT scan with contrast
- MRI, MRA, MRV
- Angiography, venography
- Blood cultures are positive during the febrile phase.
Treatment
- Medical:
- Antibiotics and supportive treatment
- Anticoagulants
- Surgical:
- Mastoidectomy with exposure of the affected sinus and drainage of the intra-sinus abscess