Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

Sinus thrombosis has rarely been associated with closed head injury; more o ften, thrombosis of the sigmoid or transverse sinus is caused by otogenic i nflammations or tumours, or occurs during pregnancy. Symptoms are frequentl y vague, while untreated thrombus progression may be fatal due to venous co ngestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neur ological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and M RA demonstrated complete thrombosis of the right sigmoid and transverse sin uses. After 2 weeks of intravenous heparin therapy followed by warfarin, th e patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an u ndetected sequel to head injury. Appropriate imaging studies should be carr ied out to enable therapy to be started as soon as possible.