Table 1.

Signs and symptoms of cerebral venous thrombosis (CVT) and location of probable lesion

Signs and symptomsProbable lesion
HeadacheMigraineAny venous occlusion/focal lesion
Raised ICP aLarge venous or sinus occlusion/large mass lesion
ThunderclapAny venous occlusion/subarachnoid haemorrhage
Ear/mastoid painTransverse sinus with/without infection
Focal neurological deficitsHemiparesisInfarction/haemorrhage/venous oedema
Cranial nerve palsy
III, IVCavernous sinus
VCavernous sinus/superior petrosal sinus
VICavernous sinus/inferior petrosal sinuses/raised ICP
VIITransverse/sigmoid sinus
VIIITransverse/sigmoid sinus/raised ICP
IX, X, XIPosterior cavernous sinus/internal jugular vein/deep venous system
AphasiaFocal infarction/haemorrhage/superficial or deep venous system
Sensory disturbanceFocal infarction/haemorrhage/superficial or deep venous system
Inattention/neglectFocal infarction/haemorrhage/superficial venous system
AtaxiaCerebellar veins/raised ICP
SeizuresFocalFocal infarction/haemorrhage
GeneralisedFocal infarction/haemorrhage/severely raised ICP
Visual disturbanceReduced acuityRaised ICP
Reduced/altered visual fieldRaised ICP/Posterior infarction/haemorrhage/raised ICP (false localising sign)
DiplopiaCavernous sinus/petrosal sinus/raised ICP
PapilloedemaRaised ICP
MeningismNeck pain/stiffnessSuggests infectious or inflammatory aetiology
Reduced consciousnessDrowsinessDeep venous system/straight sinus/raised ICP/non-convulsive status epilepticus
Cognitive impairmentEncephalopathyDeep venous system/temporal-parietal lesion (vein of Labbe)/seizures
Reduced concentration
  • aRaised intracranial pressure (ICP) can result from a combination of a large venous/sinus occlusion or from large infarction/haemorrhage.