Sudden Onset Loss of Consciousness of a Multiple Cerebral Venous Sinuses Thrombosis Case, Accompanying With the Patient History of Dehydration and Fasting as Aggravating Factors: A Case Report and Literature Review

Abstract

Cerebral venous sinus thrombosis (CVST) is a rare medical condition with probable devastating clinical consequences. It is a dilemma of clinical diagnosis because of its variable vague initial clinical symptoms. Sudden onset loss of consciousness is not an expectable initial clinical scenario. Here we report a 32-year-old female of Iranian ethnicity complaining of a short restricted vague headache episode, which started 1 hour before emergency department arrival. Shortly after arrival on emergency department, the patient complicated with sudden onset thunderclap form loss of consciousness accompanying with severe sweating. On investigation, diagnosis of multiple cerebral sinuses thrombosis was confirmed by magnetic resonance venography. For religious ceremonies, she has been fasting for several days before clinical symptoms were developed, and she has been also on oral contraceptive pills diet for a long time. Dehydration and fasting may be an aggravating predisposing factor with synergism effects. Possibly prolonged duration of dehydration due to fasting may have a significant role in mediating multiple CVST in our reported case. Due to multiple cerebral venous sinuses involvement, the mentioned case clinical scenario cannot be well matched with the persistent described clinical category structures of the literatures. This clinical symptom presentation form of sudden onset loss of consciousness is a more rare clinical manifestation of CVST. Complex vague different primary clinical presentation of CVST and its devastating probable clinical consequences necessitate more careful clinical vision in respect of correlated symptoms to rule out possible cerebral sinus thrombosis diagnosis. In this case report, we purpose to focus concentration on possible uncommon vague clinical presentation of CVST. J Neurol Res. 2015;5(4-5):257-260 doi: http://dx.doi.org/10.14740/jnr340e