Sinus thrombosis after a jump from a small rock and a sneezing attack: minor endothelial trauma as a precipitating factor for cerebral venous thrombosis?
Cerebral venous thrombosis (CVT) associated with minor or trivial head trauma has only been described in a few cases so far. We report two patients who developed CVT after a sudden intracranial pressure increase and head acceleration. A 49-year-old woman jumped from a small rock, 1 m in height, and developed instantaneous occipital headaches. Magnetic resonance imaging (MRI) confirmed confluens sinuum thrombosis. Risk factors consisted of smoking and oral contraceptives. Our second patient, an 18-year-old woman, experienced instantaneous headaches after a sneezing attack. Superior sagittal and right-sided transverse sinus thrombosis were confirmed by venous computed tomography angiography. She took oral contraceptives as an additional risk factor. In about 20% of CVT cases the cause remains unclear. As minor head trauma may not have been recognized during history taking, this may represent a so far under-recognized precipitating factor for CVT.
Department of Neurology, University of Giessen, Germany.
Carina
C
Röttger
Susan
S
Trittmacher
Tibo
T
Gerriets
Manfred
M
Kaps
Erwin
E
Stolz
D000293:Adolescent; D002550:Cerebral Veins; D003276:Contraceptives, Oral; D006259:Craniocerebral Trauma / Q000150:complications*; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000209:etiology*; D008875:Middle Aged; D015985:Precipitating Factors; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000209:etiology*; D012912:Sneezing; D020246:Venous Thrombosis / Q000209:etiology*
D003276:Contraceptives, Oral