What are the main causes of sigmoid sinus thrombosis?
The sigmoid sinus is also one of the cerebral venous sinuses, which directly receives the venous blood flowing through the transverse sinus, and indirectly connects with the medial and lateral cerebral veins, the medial and lateral hemispheric veins, and the basal cerebral veins. The main cause of sigmoid sinus thrombosis is bacterial infection, while the primary focus of inflammation is mostly mastoiditis (high bone in the back of the ear) and otitis media. After mastoiditis and otitis media appear clinically, due to improper treatment, sudden systemic infection, increased intracranial pressure and facial stroke should be considered as this disease.
What are the symptoms of sigmoid sinus thrombosis?
When the sigmoid sinus thrombosis occurs, the following symptoms can occur:
- Edema, pain, and venous distension (commonly known as tendon exposure) in the mastoid process (high bone raised behind the ear).
- Manifestations of systemic bacterial infection, such as chills and fever, and increased white blood cells were found in ear blood.
- Increased intracranial pressure. The symptoms are severe headache and vomiting. Examination of the fundus with funduscopy can reveal papilledema of the optic nerve.
- Facial apoplexy occurs. The affected eye can’t squint outward, one side of the face is numb, and some have muscle paralysis around the eyes. When the thrombosis extends to the jugular vein, it can paralyze the glossopharyngeal nerve, accessory nerve and vagus nerve, and cause soft palate ptosis on the diseased side, uvula deviation to the healthy side, pharyngeal reflex disappearance, dysphagia, hoarseness and dysarthria.
- lumbar puncture for cerebrospinal fluid can find that the pressure of cerebral blood vessels increases, and there are red and white blood cells in cerebrospinal fluid.
There are three main methods to treat sigmoid sinus thrombosis:
- apply antibiotics in large quantities. We should pay attention to the targeted and rational use of antibiotics, which is not only effective for bacterial infection of sigmoid sinus and related veins, but also has a positive therapeutic effect on primary focus otitis media and mastoiditis.
- Application of dehydrating agent. Mannitol intravenous infusion is generally used for intracranial hypertension.
- hormone therapy. Hydrocortisone or dexamethasone can be used.