Abstract
IntroductionCerebral venous sinus thrombosis is a rare condition. The most frequent symptoms and signs are headache, focal seizures with or without secondary generalization, unilateral or bilateral paresis and papilledema. We report a case of transverse sinus and superior sagittal sinus thrombosis that presented with diplopia in a pregnant woman.Case presentationA 34-year-old Malay woman, gravida 3 para 2 at 8 weeks of pregnancy, was admitted for hyperemesis gravidarum, presented with sudden onset of diplopia, blurring of vision and headache. A magnetic resonance scan of her brain showed the presence of cerebral edema with no space occupying lesion, but magnetic resonance venography ultimately revealed right transverse sinus and superior sagittal sinus thrombosis. The patient was treated with anticoagulation for 1 year, after which the patient recovered fully.ConclusionDue to its diverse and varied neurological presentation, cerebral venous sinus thrombosis should be considered in almost any brain syndrome.
Highlights
Cerebral venous sinus thrombosis is a rare condition
Due to its diverse and varied neurological presentation, cerebral venous sinus thrombosis should be considered in almost any brain syndrome
Patients who are at risk of developing venous thrombus formation are those with hypercoagulable states, dehydration, adjacent infectious processes, low cerebral blood flow, oral contraceptives, hormone replacement therapy, pregnancy, and puerperium [1,2,4]
Summary
Cerebral venous sinus thrombosis is a rare condition and its clinical presentation is extremely variable and life-threatening [1,2]. She was completely well previously with no significant medical history She had never experienced similar symptoms during her previous pregnancy and there was no family history of similar conditions noted. Magnetic resonance venography (MRV) revealed right transverse sinus and superior sagittal sinus thrombosis (Figure 2). Her coagulation profile and blood investigations for. MRV was repeated at 1 month after the initiation of treatment and showed resolved cerebral venous sinus thrombosis (Figure 3). Because cerebral venous sinus thrombosis poses a high risk of thromboembolism in this patient and no other safer drug was available, warfarin was subsequently initiated. The baby was born at 38 weeks period of amenorrhea via spontaneous vaginal delivery with birth weight of 2.8kg, without any complication and there was no identifiable syndrome noted
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