Thrombosis of deep cerebral veins in form adults: clinical features and diagnostic approach

Thrombosis of deep cerebral veins is a rare condition, and is associated wi th a poor prognosis. We report four new cases observed between 1994 and 199 7, AN four cases were women. aged less than 45 years. Initial symptoms asso ciated alteration of consciousness, change in mental status, progressive he adache and vomiting. We observed also uni or bilateral signs of long tract injury. In three cases, diagnosis initially suspected by CT scan was confir med with encephalic MRI. For the last patient, conventional angiography was needed. Thrombosis affected straight sinus, vein of Galien and infernal ce rebral veins in all patients. Basilar veins were also affected in one patie nt, without dural sinuses extension. Lateral sinus was involved in two othe rs cases, and superior sagittal in the last patient. Etiology remains undet ermined in one patient, associated with post-partum, use of oral contracept ive pill, and familial protein S deficiency, one case each. Outcome was fav orable in all four cases with anticoagulation therapy Precocity of diagnosi s is determinant and MRI is usefull in this issue. These observations show that evolution of deep veins thrombosis can be favorable, without needing f ibrinolytic therapy.