A treatise on the principles and practice of medicine . thrombosis is bilateral; suggillations in the pia,bloody imbibition of the brain or reddening of the cerebrospinal or ven- SINUS THROMBOSIS 785 tricular fluid may occur. Simple or septic pulmonary infarcts occur in50 per cent. Symptoms and Diagnosis.—Clinical signs may be absent. 1. Extracranial Stasis.—(a) In thrombosis of the superior longitu-dinal sinus, stasis in the nasal veins is often shown by epistaxis, aneffort of nature to deplete the cerebral congestion. Gerhardt observedcyanosis in the anterior frontal veins and edema in the t
A treatise on the principles and practice of medicine . thrombosis is bilateral; suggillations in the pia,bloody imbibition of the brain or reddening of the cerebrospinal or ven- SINUS THROMBOSIS 785 tricular fluid may occur. Simple or septic pulmonary infarcts occur in50 per cent. Symptoms and Diagnosis.—Clinical signs may be absent. 1. Extracranial Stasis.—(a) In thrombosis of the superior longitu-dinal sinus, stasis in the nasal veins is often shown by epistaxis, aneffort of nature to deplete the cerebral congestion. Gerhardt observedcyanosis in the anterior frontal veins and edema in the temples betweenthe great fontanelle and ear (by way of the emissaria Santorini throughthe foramen parietale). Edema is often absent in chlorotic thrombosis.(b) In thrombosis of the cavernous sinus stasis develops in its tributaries,producing exophthalmos, edema of the lids and conjunctiva (vena oph-thalmica); retinal stasis, more rarely choked disk or retinal thrombosis, VEINS COMMUNICATING THROUGHTHE PARIETAL FORAMEN WITHTHE EXTERNAL SKULL CONFLUENSSIN. \ /•VENA VENA JUGULARIS EXT. Fig. 59. -Leubes diagram showing the connections (*) of the superior longitudinal sinuswith the external veins. results from congestion of the vena centralis retinae. Sometimes edemaof the forehead results, (c) In thrombosis of the lateral sinus, edemabehind the ear and in the neck (communicating with the posterior auricularvein) occurs in over 50 per cent. Occasionally the sivollen thromboticinternal jugular vein may be felt. The external jugular collapses, or ifthe internal jugular is thrombosed it becomes overfilled (Gerhardt).In 33 per cent, the disk is hyperemic and in another 33 per cent, there ischoked disk from complicating abscess or meningitis. 2. Intracranial Stasis.—Progressive clouding of the mind, deliriumin adults, convulsions in children, conjugate deviation of the eyes andhead, stiff neck, vomiting, headache, irregular pupils, nystagmus orstrabismus are not
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