Thrombosis of the sigmoid sinus – current views on diagnosing and treatment

Czech version

Authors: Viktor Chrobok ¹; A. Pellant ^1,2; E. Ehler ³; K. Pokorný ¹; E. Šimáková ⁴; M. Mrklovský ⁵; V. Němec ⁶
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku Krajská nemocnice Pardubice ¹; Fakulta zdravotnických studií Univerzita Pardubice ²; Neurologické oddělení Krajská nemocnice Pardubice ³; Fingerlandův ústav patologie Fakultní nemocnice a Lékařská fakulta UK, Hradec Králové ⁴; Radiodiagnostické oddělení, Krajská nemocnice Pardubice – Radiologické centrum, společnost Multiscan Pardubice ⁵; Dětské oddělení, Krajská nemocnice Pardubice ⁶
Published in: Cesk Slov Neurol N 2007; 70/103(4): 424-428
Category: Case Report

Vytvořeno s částečnou podporou grantového projektu IGA MZ NR 8376-3/2005.

Overview

Three case studies demonstrate current views on the diagnosing and treatment of thrombosis of the sigmoid sinus. The factors causing thrombosis are of infectious and non-infectious nature. The cause of infectious thrombosis is acute mastoiditis which is frequent in children and is usually linked with a state of hypercoagulation, or a long-term chronic middle ear inflammation with cholesteatoma, especially in adult patients with an immune system disorder or diabetes mellitus. Non-infectious thrombosis primarily develops as a result of disturbed coagulation and prevailingly affects young women, female smokers, pregnant women or women taking hormonal contraception. The treatment of inflammatory otogenous thrombosis of sigmoid sinus is based on the administration of antibiotics and surgical sanitation of the temporal bone; administration of anticoagulation medication and surgical treatment of the thrombus is still an issue. On the other hand, anticoagulation therapy is a key element in non-infectious sigmoid sinus thromboses. Targeted detection of inborn or acquired thrombophilic state is necessary in all patients with sigmoid sinus thrombosis.

Key words:
sigmoid sinus thrombosis – etiology – diagnosing – treatment – CT – MRI – mastoiditis – cholesteatoma

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