Sinus thrombosis is a special type of thrombosis. The condition is primarily characterized by blood clots occurring in large cerebral veins. These blood clots are also called thrombi, and in the case of sinus thrombosis, they are concentrated in the area of the hard skin of the brain. This is also called sinus durae matris by medical term, from which the name of the disease is derived.
What is sinus thrombosis?
Basically, sinus thrombosis is associated with various complications. One particularly significant risk is that they may trigger strokes in the brain. The disease is also called sinus vein thrombosis in some cases, but the short form ‘sinus thrombosis’ is more commonly used. The typical symptom of the disease is that a so-called cerebral sinus closes. Based on current knowledge, the exact prevalence of sinus thrombosis is unknown. Estimates of the frequency of the disease are about three to five new cases per million persons per year. Among these, female patients are three times more likely to be affected by sinus thrombosis than males. Individuals are on average between 30 and 40 years old at the onset of the disease. Sinus thrombosis occurs far less frequently than occluded arteries. It is also true that children are less likely to develop sinus thrombosis than adults.
Causes
The causes for the occurrence of sinus thrombosis vary. In some cases, infections with pus in the area of the face or suppuration of the sinuses are responsible for the development of the disease. Meningitis or so-called mastoiditis may also lead to the formation of sinus thrombosis. If such causes are present, the disease is also called septic sinus thrombosis. In addition, it is possible that various disorders of blood coagulation trigger sinus thrombosis. In this case, the coagulation of the blood is usually increased, for example in the context of an antithrombin deficiency. In principle, pregnant women are at above-average risk for such coagulation disorders. In addition, special contraceptives and drugs also have a negative effect on blood clotting. In principle, not every blood clot develops into a sinus thrombosis with corresponding symptoms. In some cases, reversal of blood flow is possible or the thrombus dissolves. Other infectious causes of sinus thrombosis include sinusitis, tonsillitis, abscesses on the teeth or brain, and empyema. Potential generalized causes of the disease include tuberculosis or typhoid fever, measles, and malaria.
Symptoms, complaints, and signs
Sinus thrombosis is characterized by a variety of symptoms. For example, at the beginning, pain in the area of the head and epileptic seizures are often possible, up to changes in the personality of the affected person. In later stages of sinus thrombosis, there may be disturbances of vision, clouding of consciousness and paralysis of the body. Sometimes the affected patients suffer from unconsciousness. If sinus thrombosis is present with infectious causes, individuals often suffer from fever. This is the case, for example, with meningitis as well as sinusitis. However, it should also be noted that sinus thrombosis takes an asymptotic course in about one third of all sufferers. In the other cases, the symptoms are often ambiguous and do not point to a single disease, making therapy more difficult. One of the late consequences of sinus thrombosis is increased pressure in the brain, which is associated with considerable complications. In the worst case, the ill person dies from sinus thrombosis.
Diagnosis and course of the disease
The diagnosis of sinus thrombosis is usually difficult, because the symptoms that occur indicate numerous different diseases. In principle, a physician should be informed when typical symptoms appear. The physician will first conduct an intensive discussion with the patient, the so-called anamnesis. The doctor will discuss the exact symptoms and the person’s lifestyle and consumption habits. Past illnesses are also discussed. In this way, the physician obtains information regarding the current illness. After the patient interview, the focus is on the clinical picture of the disease.For example, in sinus thrombosis, it is indicated to check the D-dimer level. In addition, brain imaging techniques are used to diagnose sinus thrombosis. MRI scans can detect a blood clot or, alternatively, the causative hemorrhage. During blood analyses, the erythrocyte sedimentation rate and the C-reactive protein as an inflammation marker are checked. In addition, the number of leukocytes in the blood is determined.
Complications
If left untreated, sinus thrombosis leads to death in the majority of cases. Prior to this, complications such as epileptic seizures, paralysis, and impaired vision or consciousness occur. If the condition is then left untreated, blood rushes to the brain and eventually a stroke occurs. A stroke always results in serious complications: the affected person usually suffers from neurological and mental deficits or dies shortly after the stroke. In either case, there is permanent brain damage, which significantly reduces the quality of life and well-being of the affected person. Drug treatment for sinus thrombosis can cause side effects, drug interactions, and allergic reactions. The drug heparin, which is typically prescribed, often results in hypersensitivity reactions such as skin redness, itching, and burning. In the event of an overdose, the bleeding tendency may be exacerbated. In addition, symptoms such as pain in the limbs, itching, hives and nausea with vomiting may occur. Cramping of the bronchial muscles associated with shortness of breath, drop in blood pressure, and platelet deficiency also cannot be ruled out. Infections may occur with intravenous drug administration. In the case of prolonged therapies, germ colonization may occur within a few days. This often results in thrombophlebitis, bacteremia, and/or sepsis. Abscesses and hematomas may also occur.
When should you see a doctor?
Sinus thrombosis must always be treated promptly by a physician. The condition does not heal on its own, which is why professional help is always necessary. If sinus thrombosis is not treated, the worst-case scenario can result in the death of the affected person if too much stress is placed on the heart. A doctor should be consulted for sinus thrombosis if the affected person suffers from severe headaches or severe neck pain. In most cases, there is also a significant decrease in vision, and most sufferers may also experience unconsciousness. If these symptoms occur and do not disappear on their own, a doctor must be consulted in any case. Likewise, epileptic seizures may indicate sinus thrombosis and should also be treated. In the event of an epileptic seizure, an emergency physician should be contacted immediately. Sinus thrombosis can be investigated and treated by a cardiologist, although this usually requires surgery. The disease may also limit the life expectancy of the affected person.
Treatment and therapy
With regard to the treatment of sinus thrombosis, various measures and options exist. Initially, affected patients receive the substance heparin in high doses. Later, anticoagulants are used over a period of at least six months and are taken orally. The drug phenytoin reduces the likelihood of seizures. If there is increased pressure in the brain, the drug mannitol is usually administered. Sinus thrombosis with infectious causes should be treated with antibiotics. In the majority of cases, patients recover completely with adequate therapy.
Prevention
Meaningful measures for the prevention of sinus thrombosis have hardly been tested at present, so no definite statements can be made in this regard.
Follow-up care
In the case of sinus thrombosis, it is primarily important to diagnose the disease at an early stage so that complications or other complaints do not arise in the further course. It can occur thereby usually also not an independent healing, so that the person concerned with this disease should always see a doctor very early. The earlier a doctor is contacted, the better the further course of the disease usually is. As a rule, those affected by sinus thrombosis are dependent on taking various medications and drugs to alleviate the symptoms.A correct dosage and also a regular intake should always be observed. Only in this way can the complaints be properly limited. In case of uncertainty or questions, a doctor should be consulted first. Likewise, alcohol should not be drunk when taking antibiotics, as this can otherwise reduce the effect. Sinus thrombosis can usually be cured relatively well, so that the life expectancy of the affected person is not reduced. Further measures of an aftercare are not available to the affected person and are usually not necessary.
What you can do yourself
In the case of disorders of blood flow, the affected person should ensure that his blood circulation is sufficiently supported in daily activities. In everyday life, therefore, postures that could lead to congestion of the blood should be avoided. Adopting a rigid posture or bent limbs contribute to impaired blood flow. If there is a tingling sensation on the skin, sensitivity problems, cold fingers or feet, and a decrease in physical performance, posture optimizations should be made. Since sinus thrombosis can lead to a life-threatening condition, cooperation with a physician is necessary. In support of this, training sessions can be carried out on one’s own responsibility, which contribute to an improvement in blood circulation. Regular movements and wearing wide clothes help to minimize the risk of blood stasis in the organism. Movement over long distances should be well planned in advance. It is essential to take into account the required freedom of movement during transport. In addition, wearing thrombosis stockings can be very helpful in everyday life. Sports activities should take place regularly to stimulate blood circulation. In addition, food intake can promote blood formation and stimulate blood pressure. These are self-help measures that should be considered as support. They do not achieve freedom from symptoms or permanent recovery.