Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 24-08: Stroke + Key Features Download Section PDF Listen +++ ++ May occur in association with Intracranial or maxillofacial infections Hypercoagulable states Polycythemia Sickle cell disease Cyanotic congenital heart disease May also occur in pregnancy or during the puerperium Genetic factors are also important + Clinical Findings Download Section PDF Listen +++ ++ Headache Focal or generalized convulsions Drowsiness Confusion Increased intracranial pressure Focal neurologic deficits Meningeal irritation (less common) + Diagnosis Download Section PDF Listen +++ ++ Confirmed by CT, MR venography, or angiography + Treatment Download Section PDF Listen +++ ++ Anticonvulsant drugs if seizures have occurred If necessary, measures to reduce intracranial pressure Anticoagulation with dose-adjusted intravenous heparin or weight-adjusted subcutaneous low-molecular-weight heparin followed by oral warfarin for 6 months reduces morbidity and mortality of venous sinus thrombosis Dabigatran showed similar efficacy to warfarin in one randomized trial and may be an acceptable alternative Concomitant intracranial hemorrhage related to the venous thrombosis does not contraindicate heparin therapy In cases refractory to heparin, endovascular techniques including catheter-directed thrombolytic therapy (urokinase) and thrombectomy are sometimes helpful but may increase risk for major hemorrhage