SEPTIC THROMBOSIS OF THE LEFT TRANSVERSE SINUS: A CASE REPORT

Abstract

Introduction: Septic thrombosis of the cerebral venous sinuses is a rare and potentially fatal condition resulting from the spread of local or systemic infections that culminate in the formation of contaminated thrombi in the dural sinuses. Involvement of the transverse sinus is uncommon, and its diagnosis requires high clinical suspicion and confirmation by neuroimaging. Objective: To report a case of septic thrombosis of the left transverse sinus associated with a brain abscess, emphasizing the clinical course and therapeutic approach. Case Report: A 42-year-old man with hypertension, diabetes, and chronic kidney disease on hemodialysis was admitted with sudden and severe headache, nausea, and vomiting. CT scan revealed left temporo-occipital hemorrhage. He developed seizures, followed by conjunctival hyperemia, eyelid edema, and periorbital pain. Magnetic resonance imaging revealed an occipital abscess and disseminated encephalitis. Venous CT angiography confirmed thrombosis of the transverse sinus and left internal jugular vein. Broad-spectrum intravenous antibiotic therapy and anticoagulation adjusted to renal function were instituted, with progressive improvement in the neurological and infectious symptoms. Discussion: Septic transverse sinus thrombosis is a serious complication of intracranial or systemic infections, whose pathophysiology involves the extension of the infection to the dural venous system, resulting in septic thrombophlebitis and formation of brain abscesses. Conclusion: Septic transverse sinus thrombosis, although rare, should be considered in patients with sudden headache and ocular or neurological signs of infection, especially in individuals with chronic comorbidities. A multidisciplinary approach, with imaging diagnosis and combined treatment with antibiotics and anticoagulants, is essential to reduce associated morbidity and mortality.