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Investigations

Authoring team

The investigation of cerebral venous thrombosis should include:

  • blood cultures for infection
  • lumbar puncture, which may show:
    • slightly raised CSF pressure
    • increased protein
    • pleocytosis, indicating a spread of infection to neighbouring leptomeninges
  • CT scan - so as to discriminate from cerebral abscess, which is difficult on clinical grounds alone. Delta sign - filling defect within the sinus following contrast administration - seen in superior sagittal sinus thrombosis.
  • MRI scan - now succeeding CT as an investigative mode
  • carotid angiography - if blockage of cavernous sinus, there may be an obvious filling defect in the venous phase after administration of contrast.

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