Which physical findings are characteristic of thrombophlebitis of the dural sinuses?

Updated: Oct 05, 2021
  • Author: JE Robyn Hanna, MD, MS; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

The physical findings of thrombophlebitis of the dural sinuses can be specific to the particular sinus involved. Cavernous sinus pathology results in fever in 94% of patients; the triad of ptosis, proptosis, and chemosis in 95% of patients; extraocular movement palsies in 88% of patients; and abnormal fundi in 65% of patients. Other notable signs are lethargy; abnormal ear, nose, and throat (ENT) examination findings; and nuchal rigidity. [12]

An abnormal ear examination, such as posterior auricular swelling and tenderness, purulence from a ruptured tympanic membrane (TM), or a dull, erythematous TM, was noted in 98% of patients with lateral sinus thrombosis. Sixty-five percent of patients with sagittal sinus septic thrombophlebitis present with altered mental status, while 61% have motor deficits. [12]


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