Four full-term newborns with transverse sinus thrombosis (TST) and a benign outcome are described from the Children's Hospital of Los Angeles and USCSM, and the University of Texas Medical School, Houston, TX. The infants presented with irritability, jitteriness, and mild hypertonia. One had seizures and 3 had abnormal EEGs with temporal or central sharp waves. The CSF was xanthochromic and contained excess red blood cells. In 2 of 4 followed up, the neurological exam was normal. MRI scans which permit diagnosis of TST show a hyperintense signal of the sinus thrombosis in Tl- and T2- weighted images and subdural and subarachnoid hemorrhages. Partial thrombosis can be seen as a ring of central hyperintense signal surrounded by a halo of signal void that corresponds to flowing blood. The authors suggest that TST may be relatively common, with a wide spectrum of severity. [1]
COMMENT. Sinus thromboses in newborns are most commonly associated with birth trauma and intracranial hemorrhage. A mild tentorial laceration was considered likely in the cases reported. An inherited protein C deficiency may be manifested by massive venous thromboses in the newborn [2], an etiology to be considered in the absence of a history of brain trauma.