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To the Editor.—
In their recent article "Superior Sagittal Sinus Thrombosis" (Arch Neurol 34:2, 1977), Drs Gettel-finger and Kokmen recommend that anticoagulants not be used, but rather that one should rely on antiedematous agents and anticonvulsants. We wish to report briefly two recent cases that led us to a different conclusion.
Report of Cases.—
Case 1.—A 69-year-old right-handed woman developed a right brachial monoplegia within a few hours. On admission the same day (Dec 12, 1975), she was apathetic, but not confused or dysphasic. There was a dense right brachial monoplegia with decreased reflexes and a right extensor plantar response. Findings from general examination, temperature, and routine blood tests were normal. On lumbar puncture, CSF protein level was 76 mg/100 ml and RBC count, 9,000/cu mm.She was given oral glycerin and dexamethasone (4 mg intramuscularly every six hours), but her condition deteriorated over the next ten days. She