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Published online by Cambridge University Press: 02 June 2017
Background: Intracranial hemorrhage due to sagittal sinus thrombosis is an unusal inital clinical presentation and a series of 3 cases is presented. Methods: A retrospective study of stroke patients seen at the William Osler Health System between 2014 -2016. Results: 1: 43 y.o. female presented with headaches and right hemiparesis. CT and MRI/MRV showed L. parietal intra-cerebral hemorrhage and sagittal and transverse sinus thrombosis. She was treated with IV heparin and subsequent oral Warfarin but developed symptomatic left subdural hematoma which was successfully evacuated. Hypercoagulable workup was negative. Subsequent MRI/MRV showed resolution of her sinus thrombosis and received asparin only since. 2: 45 y.o. male presented with generalized seizure 10 days following a motor vehicle accident. Initial CT showed focal right frontal subarachnoid hemorrhage and subsequent MRI/MRV confirmed extensive sagittal sinus thrombosis. He was treated with IV heparin and subsequent Warfarin without any complications. 3: 32 y.o. male presented with generalized seizure. CT and MRI/MRV confirmed a large right temporal lobe intra-cerebral hemorrhage and extensive right transverse sinus and straight sinus thrombosis. He was successfully treated with IV heparin followed by oral Warfarin. Conclusions: Despite intracranial hemorrhage in patients with cerebral sinus venous thrombosis, they could be managed successfully with anticoagulation therapy and with careful clinical and neuro-imaging monitoring.