Nonmetastatic superior sagittal sinus thrombosis complicating systemic cancer

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Abstract
Seven patients with cancer complicated by nonmetastatic sagittal sinus thrombosis were encountered in a 7 yr period. Five had hematologic malignancies and 2 had solid tumors. There were 2 different presentations. In the 1st, neurologic signs and symptoms (e.g., headaches, seizures, hemiparesis, lethargy) occurred suddenly in 5 patients shortly after initiation of cancer therapy. Four of these 5 patients receovered with minimal residua; the 5th died as a direct result of the sinus thrombosis. The 2nd presentation occurred in the 2 patients with terminal cancer who declined gradually without focal signs; both patients died. Only arteriography can reliably establish the diagnosis of sagittal sinus occlusion. In patients with cancer, sagittal sinus occlusion probably results from a hypercoagulable state associated with the systemic neoplasm.