Doppler imaging of superior sagittal sinus thrombosis

Three cases of neonatal superior sagittal sinus thrombosis diagnosed by Doppler imaging and confirmed with either computed tomography, magnetic resonance imaging, or digital subtraction angiography are described. One infant died and the others had uneventful recovery. Young infants with superior sagittal sinus thrombosis rarely are seen for diagnostic imaging; the nonspecificity of the clinical presentation of this disorder and the difficulties with its investigation owing to the invasiveness of the radiologic procedures lead to its underdiagnosis. Magnetic resonance imaging is a sensitive, noninvasive diagnostic modality, but it is not always available and practical for the very sick infants in the critical care unit. In the cases described here, Doppler imaging proved to be diagnostic and useful in the management of superior sagittal sinus thrombosis and should be used in the initial assessment of the condition, as it is the most convenient and least traumatic diagnostic modality.