Transverse sinus thrombosis is a rare type of stroke caused by a blood clot in the brain. It requires immediate medical care to prevent life threatening complications.

This condition falls under the umbrella of cerebral venous sinus thrombosis (CVST), meaning there is a blood clot in one of the veins in the brain. CVST is a rare form of stroke and makes up only 0.5–2% of strokes in developed countries, including the United States, but is more common in developing countries.

Doctors can effectively treat CVST and transverse sinus thrombosis when necessary treatments and diagnostic tools are available.

This article discusses further details of transverse sinus thrombosis, including the symptoms, diagnostic process, treatments, and possible complications.

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The transverse sinus refers to two small tubes that run on either side of the base of the skull beneath the brain. These tubes drain blood from the cerebellum, another part of the brain.

If one of the transverse sinuses becomes blocked by a blood clot, it can cause a buildup of blood, increased blood pressure, and swelling in the brain. If the buildup damages parts of the brain, this is considered a type of stroke called transverse sinus thrombosis.

Various symptoms and signs characterize transverse sinus thrombosis. The symptoms a person experiences may vary depending on the blood clot’s size, location, and severity.

A headache is the most common symptom of venous sinus thrombosis. Other possible symptoms include:

  • seizures
  • weakness or loss of control in parts of the body
  • confusion
  • loss of vision, blurred or double vision
  • fainting
  • losing consciousness
  • vomiting

A person may experience transverse sinus thrombosis for many reasons, ranging from inherited conditions to certain types of injury.

CVST is more common in females than males. Unlike other forms of stroke, it is most likely to affect children and young adults.

Some causes of transverse sinus thrombosis include:

  • inherited thrombophilia, which is a condition that can increase the risk of blood clots
  • pregnancy or being up to 6 weeks postpartum
  • certain contraceptive pills
  • infection
  • head or brain injury
  • blood clotting problems

Other risk factors include:

  • having obesity
  • having had major surgery in the last 2 weeks
  • smoking
  • having severe anemia
  • having a brain tumor
  • having low blood pressure in the brain

Transverse sinus thrombosis can lead to a range of complications. According to research from 2013, the risk of developing complications such as intracranial hypertension (ICH) — or increased pressure in the brain — lessen if it is identified and treated early.

Besides ICH, some other possible complications include:

  • brain hemorrhage, which refers to swelling and bleeding in the brain
  • focal neurological deficits, such as weakness, difficulty with speech, loss of muscle control, changes in movement, or uncontrolled movements
  • secondary stroke
  • brain injury
  • developmental delay for children
  • seizures
  • coma

Transverse sinus thrombosis may be fatal. However, where newer imaging equipment and treatments are available — and the condition is detected early — individuals are likely to experience minimal lasting neurological complications.

A physical examination and medical history can often lead doctors to suspect that a person has transverse sinus thrombosis.

To diagnose it, doctors may need to rule out other possible conditions with similar symptoms. This may involve a CT scan, which may or may not show the blood clot.

Other tests that might be helpful include:

  • CT with contrast, which is a special type of X-ray scan where a dye is used to visualize organs or blood vessels
  • CT venography, which looks specifically at the veins in the body
  • MRI scan
  • magnetic resonance venography
  • cerebral angiography, which assesses blood flow in the brain

There are various components to treating a person with transverse sinus thrombosis in a hospital setting. Treatments may include:


Anticoagulants — sometimes called blood thinners — are the main treatment for people with CVST. These medications help reduce the risk of blood clots and, in some cases, can aid in the prevention or treatment of strokes.

Removing or dissolving existing clots

Other treatments for transverse sinus thrombosis may include:

  • Local thrombolysis: This involves delivering medications directly to the affected area through a catheter to dissolve the clot.
  • Mechanical thrombectomy: This procedure involves inserting a catheter in the groin and threading it through to the blood vessels until it reaches the blood clot. A small device then grips and removes the clot.

Seizure management

Transverse sinus thrombosis can lead to seizures, so doctors should ensure the person is safe should they experience one. This includes the following measures:

  • checking that airways are clear
  • giving oxygen
  • elevating the person’s head on the bed
  • having anticonvulsants on hand, should the individual require it

Therapies to treat intracranial pressure

It is vital that doctors also treat the increased intracranial pressure that can occur with CVST. This may involve surgery or a mannitol infusion.

Mannitol infusion is delivered intravenously. It is a diuretic that helps increase urine output and remove excess water that may cause swelling in the body.

A surgeon may also remove hematomas (a buildup of blood outside the blood vessels) to decrease pressure.

It is important to know that transverse sinus thrombosis may not always be preventable: The risk of the condition generally can be higher if someone has inherited clotting disorders.

However, certain lifestyle factors may help reduce the risk of developing transverse sinus thrombosis in some people. These include:

  • maintaining a healthy weight
  • getting regular exercise
  • eating a balanced and nutritious diet
  • avoiding smoking
  • managing chronic conditions
  • being aware of medications that may increase the chance of developing blood clots

People with CVST are likely to have favorable outcomes in cases where the necessary diagnostic tools and treatments are available.

In a 2023 study, researchers found that 57% of people with cerebral vein and dural sinus thrombosis had no lasting deficits or symptoms after 16 months. However, these figures are not for transverse sinus thrombosis specifically.

A 2020 study reports that CVST prognosis has improved within recent decades. According to the study, the mortality rate for people with CVST is below 5% in the West and 80% of people make a complete recovery.

Transverse sinus thrombosis is a rare form of stroke caused by a blood clot in one of the transverse sinuses of the brain. Symptoms can vary greatly but commonly include a headache. This stroke type is most common in young adults and children. It is also more likely to affect females.

Doctors can often treat this condition effectively when equipped with the right resources. This condition tends to have favorable outcomes with early diagnosis and treatment. Treatment options may include medications, small procedures, or surgery.