. A treatise on the nervous diseases of children : for physicians and students. generally confined to the longitudinal sinus, but may in-volve the lateral and cavernous sinuses. In such cases the clots are dense,resistant, organized, and do not adhere to the wall of the vein. The throm- 586 THE NERVOUS DISEASES OF CHILDREN. bosis may be limited to tlie cerebral veins, thus giving rise to limited or cor-tical symptoms. Gowers, it will be remembered, has attached special signifi-cance to this condition in the causation of infantile cerebral palsies. The second form is the secondary or infective
. A treatise on the nervous diseases of children : for physicians and students. generally confined to the longitudinal sinus, but may in-volve the lateral and cavernous sinuses. In such cases the clots are dense,resistant, organized, and do not adhere to the wall of the vein. The throm- 586 THE NERVOUS DISEASES OF CHILDREN. bosis may be limited to tlie cerebral veins, thus giving rise to limited or cor-tical symptoms. Gowers, it will be remembered, has attached special signifi-cance to this condition in the causation of infantile cerebral palsies. The second form is the secondary or infective thrombosis, w^hich generallyaffects the lateral, the cavernous, or the transverse sinuses. It is secondaryto some infective process in the neighboring tissues or at a distance. Middle-ear disease is the most frequent cause, but it may also be due to traumaticinjuries of the skull (infected w^ounds), erysipelas of the head and face, topurulent disease of the eyes and of the nose. In one of the authors casescaries of the jaw was the starting-point of sinus thrombosis. In other. Fig. 152.—Girl, Aged Twenty. Exophthalmus, with internal strabismus; oedema ofthe right eyehds, side of the nose, the brow, and the face. Later in the disease theleft side was also affected. Thrombosis of cavernous sinus. (Macewen.) cases the infectious material is carried along the veins and through neighbor-ing tissues. The inflammation may extend directly to the walls of the sinus and thuscause clotting of the blood within, or the clot may form v^ithin a vein andextend from there into the sinus. The superior petrosal and the lateralsinuses receive their blood from the middle ear, hence the frequency of throm-bosis of these sinuses in middle-ear disease. Thrombosis of the sinus result-ing from actual compression is very rare indeed and of little significance, asthe symptoms would be obscured by those of the primary affection. Symptoms.—The symptoms of sinus thrombosis are often complicatedby those of
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