Painful bilateral ulcerations of the hard palate

Abstract

A 27-year-old woman was admitted for a gradually worsening diffuse headache. Her medical history was relevant for heavy smoking, protein S deficiency, heterozygous status for factor V Leiden, and a previous deep vein thrombosis of the right leg. She had previously been given anticoagulation therapy, which the patient discontinued on her own. Cerebral magnetic resonance venography (MRV) revealed superior sagittal sinus thrombosis, for which anticoagulant treatment was initiated. Upon admission, the patient also complained of bilateral pain and numbness on the hard palate followed 3 days later by painful ulcerations (Fig 1).