Table 1

Clinical manifestations of cerebral venous thrombosis according to occlusion site

Occluded sinus/veinClinical presentation
Transverse sinus
If isolated without infarction: asymptomatic or headache
Contralateral pyramidal symptoms and signs
If left transverse sinus with venous infarction and vein of Labbé occlusion: aphasia
If extending into the contiguous sinuses: intracranial hypertension, consciousness disturbance, focal cerebral signs and cranial nerve palsies (IX-XXI)
If extending into the cerebellar veins: headache, vomiting, and limb or gait ataxia.
Superior sagittal sinus
Isolated intracranial hypertension
Focal symptoms due to venous infarction (see below)
Isolated psychiatric symptoms (rare)
  • Headache

  • Blurred vision

  • Visual loss

  • Nausea, vomiting

  • Cranial nerve palsy (differential diagnosis of pseudotumor cerebri)

  • Aphasia

  • Hemianopia

  • Hemisensory loss and/or hemiparesis

  • Seizures

Sigmoid sinus
Pain in the mastoid region
Combinations of VI-VII-VIII cranial nerve palsies
Deep venous system (10.9%)Mental status disturbances—reduced arousal
Diffuse encephalopathy or coma
Motor deficits (bilateral or fluctuating alternating paresis)
Cortical veins
Focal neurological symptoms and signs according to location
Cavernous sinus
Headache, ocular pain, chemosis, proptosis, ocular nerve palsy (III, IV, VI and the ophthalmic division of V)
Fever (when there is an infective cause)