Table 1

Clinical manifestations of cerebral venous thrombosis according to occlusion site

Occluded sinus/veinClinical presentation
Transverse sinus
(44–73%)		If isolated without infarction: asymptomatic or headache
Seizures
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
(39–62%)		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
(40–47%)		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
(3.7–17.1%)		Focal neurological symptoms and signs according to location
Seizures
Cavernous sinus
(1.3–1.7%)		Headache, ocular pain, chemosis, proptosis, ocular nerve palsy (III, IV, VI and the ophthalmic division of V)
Fever (when there is an infective cause)