title: Lateral Sinus Thrombosis: The Importance of the Unaffected Sinus.
abstract: Intracranial hypertension develops in only some patients with lateral sinus thrombosis (LST), for reasons that are unclear. The purpose of this study was to evaluate a possible association between patency of the unaffected sinus and clinical presentation of unilateral LST.
  
  
  
  A computerized search identified patients with LST, hospitalized in Soroka Medical Center. Patients with signs of increased intracranial pressure (iICP) and those with normal intracranial pressure (nICP) were compared. CT venography or MR venography confirmed the diagnosis, located the thrombosis, and determined the dominant lateral sinus (LS). Diameters of the right and left LSs (the occluded and unaffected) were compared to the diameter of the distal superior sagittal sinus (SSS).
  
  
  
  Of the 50 patients identified, 30 had iICP and 20 nICP. The dominant LS was the right one in 39 (78%) and the left one in 8 (16%); 3 (6%) had equal LS dominance. The dominant sinus was affected in 32 (70%) and the non-dominant in 15 (30%) patients. iICP was detected in 28/32 (81%) of patients with the dominant side affected, and 3/15 (20%) of those with non-dominant thrombotic sinus (P = .002). The unaffected sinus was narrower in iICP patients (size relative to SSS diameter = 43% in iICP vs. 86% in nICP [P = .0002]; size grading, according to Farb's method was 1.86 in the iICP vs. 3.57 in the nICP group [P = .0001]).
  
  
  
  Thrombosis was more common in the dominant LS. Unaffected LS patency appears to be associated with the development of increased ICP.
authors: Cognitive Neurology Clinic, Rabin Medical Center, Petach Tikva, Israel.
authors: Amir
authors: A
authors: Glik
authors: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.|Diagnostic Imaging Department, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Elya
authors: E
authors: Benkovich
authors: Ophthalmology Department, Neuro Ophthalmology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors: Anat
authors: A
authors: Kesler
authors: Neurology Department, Soroka University Medical Center, Beer-Sheva, Israel.|Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors: Gal
authors: G
authors: Ifergan
authors: Neurosurgery Department, Hadassah University Medical Center, Jerusalem, Israel.
authors: Moni
authors: M
authors: Benifla
authors: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. shelef@bgu.ac.il.|Diagnostic Imaging Department, Soroka University Medical Center, Beer-Sheva, Israel. shelef@bgu.ac.il.
authors: Ilan
authors: I
authors: Shelef
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003392:Cranial Sinuses / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging*; D020227:Lateral Sinus Thrombosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Cerebral venous thrombosis; headache; idiopathic intracranial hypertension