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Sinus Thrombosis After a Jump From a Small Rock and a Sneezing Attack: Minor Endothelial Trauma as a Precipitating Factor for Cerebral Venous Thrombosis?

Authors

  • Carina Röttger MD,

  • Susan Trittmacher MD,

  • Tibo Gerriets MD,

  • Manfred Kaps MD,

  • Erwin Stolz MD


  • From the Department of Neurology, University of Giessen, Giessen, Germany (Drs. Röttger, Gerriets, Kaps, and Stolz); and the Department of Neuroradiology, University of Giessen, Giessen, Germany (Dr. Trittmacher).

Address all correspondence to Dr. Carina Röttger, Department of Neurology, University of Giessen, Giessen, Germany.

Abstract

Cerebral venous thrombosis (CVT) associated with minor or trivial head trauma has only been described in a few cases so far. We report two patients who developed CVT after a sudden intracranial pressure increase and head acceleration. A 49-year-old woman jumped from a small rock, 1 m in height, and developed instantaneous occipital headaches. Magnetic resonance imaging (MRI) confirmed confluens sinuum thrombosis. Risk factors consisted of smoking and oral contraceptives. Our second patient, an 18-year-old woman, experienced instantaneous headaches after a sneezing attack. Superior sagittal and right-sided transverse sinus thrombosis were confirmed by venous computed tomography angiography. She took oral contraceptives as an additional risk factor. In about 20% of CVT cases the cause remains unclear. As minor head trauma may not have been recognized during history taking, this may represent a so far under-recognized precipitating factor for CVT.

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