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Abstract
Venous blood from the brain flows via the superficial (cortical) and the deep cerebral veins into the venous dural sinuses. There are numerous connections between the cortical veins and dural sinuses, and also with the venous system of the meninges, scalp and nasal sinuses. This facilitates the spread of thrombus or infection via the emissary veins to the intracranial venous system and adjacent brain parenchyma. The communication between the intracranial and extracranial venous system also may allow the opening of collateral draining vessels in the event of an occlusion.
To understand the symptoms and signs of sinus thrombosis, two different mechanisms should be distinguished: thrombosis of the cerebral veins, with local effects caused by venous obstruction, and thrombosis of the major sinuses, which causes intracranial hypertension and in the majority of patients, these two processes occur simultaneously.