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Hydrocephalus in Adults Secondary to Venous Sinus Thrombosis
Author(s) -
Shaw J. F.
Publication year - 1962
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.1962.tb03162.x
Subject(s) - medicine , hydrocephalus , thrombosis , sinus (botany) , surgery , meningitis , venography , venous thrombosis , botany , biology , genus
THE clinical syndrome, variously called otitic hydrocephalus, pseudo‐tumour cerebri, and benign intracranial hypertension (Lancet 1961, Paterson et al. 1961) was briefly described. It was recalled that Symonds had attributed these cases to intracranial venous sinus thrombosis following middle ear infection, causing obstruction to CSF absorption. The obvious corollary is that the same sequence of events, if indeed it occurs, could follow causes other than ear infection. However, the majority of these cases show a normal ventricular system, and a number of cases have now been reported in which brain swelling seemed to be due to an allergy or hormone electrolyte imbalance. This throws some doubt on the concepts put forward by Symonds (1931). From a critical survey of cases of hydrocephalus believed to be due to venous sinus thrombosis, the difficulties in establishing a diagnosis were noted. These included the fallibility of estimations of CSF pathways by X‐ray after air replacement, and the possibility of such an air replacement being undertaken at too early a phase of brain swelling, due to venous stasis, and before the development of hydrocephalus would have occurred. It was noted that these cases of sinus thrombosis rarely came to post mortem and, therefore, an apparently normal sinus on venography or inspection at operation could by no means exclude some degree of mural thrombus. A review of sixteen cases seen in the department of surgical neurology in the years 1950‐60 was presented. Five were classed as otitic, four were associated with infections other than in the ear and four were traumatic. In two endocrine possibilities were suggested and an allergic cause was suggested in a chronic asthmatic. In none was sinus thrombosis actually demonstrated, and all, therefore, had features which cast doubt on this diagnosis. The advantages and disadvantages of the various treatments carried out were suggested. Types of treatment included repeated lumbar puncture, theco‐peritoneal anastomosis and subtemporal decompression.