Thrombosis of the sinuses of the brain( sinus thrombosis) is referred to secondary types of disease, that is, to those that develop as a secondary process against a background of a number of pathologies, especially purulent-inflammatory. Often it is combined with vein thrombosis.
Features of the disease
Vein damage and increased blood coagulability play a significant role in the development of the disease. Many of the symptoms are associated with the spread of thrombosis to these or other sinuses and veins. Clearly diagnose and divide them into species is capable only of a specialist.
Thrombosis often affects several sinuses, and sometimes on the veins at the point of their entry into the sine. Subsequently, this leads to the fact that the infection spreads to the soft dura mater. If purulent melting of the thrombus occurs, such purulent emboli can settle in the organs of the small circle of the circulation. The outcome of this is often an abscess of the lung.
Classification and forms of
Sinus thrombosis of the brain is treated differently, depending on which area affects the pathology. From the definition of the type of disease always depends on its further treatment, and yet they have different manifestations.
The most common pathology is thrombosis of the cavernous sinus, which develops as a result of septic conditions. Especially difficult it occurs in cases when it becomes bilateral, as thrombus formation can occur already in stony and occipital sinuses. From other types of disease is characterized by the presence of infectious encephalitis, hemorrhagic strokes, orbital diseases.
It is also common to isolate thromboses of the following sinuses of the brain:
- lower and upper stony,
- lower and upper sagittal,
- occipital,
- sigmoid,
- transverse,
- straight,
- interdeep,
- wedge-parietal.
About the causes of thrombosis of the transverse and other sinuses of the brain, read on.
More details about thrombosis of the cavernous sinus will be described by the following video with Elena Malysheva:
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Causes of
Predisposing factors for sinus thrombosis are:
- diabetes mellitus;
- diseases of an infectious nature, especially affecting the area of teeth, nose, ears;
- postpartum period;
- autoimmune diseases;
- abortion;
- craniocerebral trauma;
- vascular and heart disease;
- hemostasis disorders in combination with a tendency to thrombosis;
- tumor of the brain.
Sometimes, there are no visible reasons for the development of sinus thrombosis. Such cases are idiopathic and are treated by common means.
Symptoms of
There are 3 groups of symptoms: focal, cerebral and intoxication.
- To manifestations of general cerebral nature include nausea, meningeal symptoms, low-grade fever, a feeling of aches in the joints. Sometimes with aggravation of the disease, cramps begin. The most severe cases lead to the development of coma. All the symptoms develop against the background of increased pressure inside the skull, the appearance of cerebral edema, the disturbed outflow of the CSF, which in the complex can lead to death.
- Intoxication symptoms are similar to cerebral. There is an ache, subfebrile temperature, weakness. If the thrombus formation was provoked not by infectious causes, then the described signs can not be observed.
- Focal symptomatology indicates a lesion of the brain in any area, often accompanied by a circulatory disturbance in the orbit. With a tricky sine, the manifestations will be as follows:
- obstructed movements performed by the eye;
- exophthalmos( ie, a disorder in which the eyeball protrudes);
- decreased visual acuity;
- cyanosis and swelling of the nape of the forehead, forehead and eyes.
Diagnostics
The first stage of diagnosis of sinus thrombosis is an examination and collection of an anamnesis, as well as conducting laboratory tests. So, when a patient is interrogated, the signs characteristic of the disease are revealed:
- , the headache does not go away from analgesics;
- acute onset of the attack and its constant duration;
- observed increased pain in the prone position or during physical exertion;
- worst of all a person feels at night.
Other diagnostic methods are also used:
- In addition, the patient visits an ophthalmologist who reveals specific signs of sinus of brain thrombosis. These include the presence of the eye nerve edema, the presence of vascular abnormalities on the fundus, etc.
- Laboratory tests for diagnosis include a coagulogram, a general blood test and its inoculation for sterility, measurement of the D-dimer level and determination of the composition of the cerebrospinal fluid.
- For instrumental diagnostics apply MRI, CT with the introduction of contrast in the vessels, cerebral angiography.
Knowing about the symptoms and causes of thrombosis of the sinuses of the cerebral vessels, let's talk about the treatment of the disease.
MRI and other methods for diagnosis of sinus thrombosis will tell the following video:
Treatment of sinus thrombosis
Methods of treatment are always adjusted and depend on the form and type of the disease.
Therapeutic
Therapy necessarily implies the achievement of the result for several tasks:
- detoxification,
- removal of cerebral edema,
- thrombus prevention,
- neuroprotective therapy,
- preventing further development of infection.
Medication
Conservative treatment is always performed on the basis of carefully selected medications, since it is important to prevent a fatal outcome. It is not surprising that a broad spectrum of antibiotics is used to detoxify and remove accumulated harmful substances from the body. And that the body quickly gets rid of toxins, inject infusion solutions( Hemodez, Reopoliglyukin, etc.).
- Antibiotics are administered only after blood culture, which allows to determine the resistance of the infection to certain substances. But until this point, most often used drugs with a wide range of effects, as well as drugs used to treat anaerobic infection.
- Heparinotherapy is performed to eliminate thrombi, and after its termination for the next 3 months, prescribe the reception of anticoagulants of indirect effect. Further, antiaggregants help prevent thrombosis development( Clopidogrel, Dipiridamol, Aspirin).
- Diuretics are used when there is a threat of brain edema. As for neuroprotective therapy, it is used already in the recovery period. Neurometabolic and vasodilators are used for this purpose.
Operative
Surgical intervention is infrequent, only in cases when the body does not respond to drug therapy. The operation is very difficult, as sanitizing some sinuses( for example, cavernous) is very difficult because of the anatomical structure of the skull.
In such cases, the paranasal sinus is usually opened, after which the location of the primary infection is sanitized.
Prevention of
Prophylactic methods do not include any specific recommendations. To prevent sinus thrombosis of the brain is possible only if the doctor observes and treats chronic diseases, especially those accompanied by an increase in blood viscosity or changes in the walls of the vessels.
Just as timely should treat infectious diseases, which in many cases are the cause of pathology.
About complications of thrombosis of arteries, veins, venous sinuses of the brain, read on.
Complications
Sinus thrombosis of the brain is important as soon as possible to diagnose and cure, otherwise a number of serious complications will affect your health. The consequences of pathology can be conditionally divided into remote and close. The latter include the development of edema or cerebral infarction, partial seizures.
Remote complications are no less serious:
- hypopituitarism, that is, the final cessation or reduction of pituitary hormone production;
- decreased visual acuity;
- arachnoiditis( inflammation of the brain, which provokes the formation of cysts or adhesions);
- the descent of the century;
- anisocoria( pupil difference in size);
- paresis of the nerve;
- sepsis;
- nephritis;
- is a septic endocarditis.
Forecast
As in the case of complications, the prognosis depends a lot on the time at which sinus thrombosis was detected.
- Accordingly, the chances of recovering are much greater in a patient who started early therapy.
- Mortality from the disease is about 20%, and another 10% of patients in the near future develops a sinus sinus thrombosis.