Cranial nerve syndrome in thrombosis of the transverse/sigmoid sinuses.
Cerebral venous thrombosis (CVT) is a cerebrovascular disease associated with a wide variety of clinical signs and symptoms, which may often delay appropriate diagnosis. Single or multiple cranial nerve palsies (III-VIII) without evidence of other signs and symptoms have not, so far, been considered a relevant syndrome of CVT. This event turned out to be a characteristic finding in five patients with thrombosis of the ipsilateral transverse/sigmoid sinus, who were recruited prospectively over a 14-month period. The diagnosis was supported by non-invasive MRI with the application of a newly developed subtraction technique. In view of the considerable mimics of the syndrome, and the long-standing need for conventional angiography to confirm the disease, it is likely to have been underestimated in the past; since appropriate treatment seems possible the diagnosis and utility of early MR venography should be considered in patients with single or multiple cranial nerve lesions of uncertain aetiology.
Kuehnen
J
J
Department of Neurology, University of Heidelberg, Klinikum Mannheim, Germany.
Schwartz
A
A
Neff
W
W
Hennerici
M
M
D000328:Adult; D000368:Aged; D000716:Anatomy, Artistic; D002550:Cerebral Veins / Q000473:pathology; D003389:Cranial Nerve Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000175:diagnosis; D013382:Subtraction Technique; D013577:Syndrome