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Brain, Vol 121, Issue 2 381-388, Copyright © 1998 by Oxford University Press

ARTICLES

Cranial nerve syndrome in thrombosis of the transverse/sigmoid sinuses

J Kuehnen, A Schwartz, W Neff and M Hennerici
Department of Neurology, University of Heidelberg, Klinikum Mannheim, Germany.

Cerebral venous thrombosis (CVT) is a cerebrovascular disease associated with a wide variety of clinical signs and symptoms, which may often delay appropriate diagnosis. Single or multiple cranial nerve palsies (III-VIII) without evidence of other signs and symptoms have not, so far, been considered a relevant syndrome of CVT. This event turned out to be a characteristic finding in five patients with thrombosis of the ipsilateral transverse/sigmoid sinus, who were recruited prospectively over a 14-month period. The diagnosis was supported by non-invasive MRI with the application of a newly developed subtraction technique. In view of the considerable mimics of the syndrome, and the long-standing need for conventional angiography to confirm the disease, it is likely to have been underestimated in the past; since appropriate treatment seems possible the diagnosis and utility of early MR venography should be considered in patients with single or multiple cranial nerve lesions of uncertain aetiology.
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