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Dural sinus thrombosis: a mechanism-based classification and review of 42 cases

V P Saw, C Kollar, I H Johnston

    Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
    |July 22, 2008
    PubMed

    Insights

    Dural sinus thrombosis can cause serious neurological issues, but this study found a good prognosis for most patients. Understanding the mechanism of dural sinus thrombosis aids in classification and treatment.

    Area of Science:

    • Neurology
    • Vascular Medicine
    • Radiology

    Background:

    • Dural sinus thrombosis can lead to venous hypertension, cerebral infarction, hemorrhage, or pseudotumor syndrome due to impaired cerebrospinal fluid absorption.
    • A mechanism-based classification is proposed for dural sinus thrombosis based on these potential outcomes.

    Purpose of the Study:

    • To classify dural sinus thrombosis based on its mechanism and outcomes.
    • To review cases and analyze the relationship between thrombosis site, presentation, treatment, and prognosis.

    Main Methods:

    • Retrospective review of 42 dural sinus thrombosis cases (1986-1997).
    • Classification based on presentation mechanism and relevance to thrombosis site.
    • Diagnosis primarily via Magnetic Resonance Imaging (MRI) with venous flow studies; angiography as gold standard.

    Main Results:

    • Superior sagittal and transverse sinuses are the most common thrombosis sites.
    • Multiple thrombosis sites (69%) are more frequent than single sites.
    • Pseudotumor syndrome (43%) and cerebral hemorrhage (31%) are the most common presentations.

    Conclusions:

    • Dural sinus thrombosis has a generally good prognosis, with 71% of patients recovering normal function.
    • Mechanism-based classification can inform treatment and predict outcomes.
    • Early diagnosis using MRI with venous flow studies is crucial.

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