Presentation
Two weeks of worsening pressure headache. New vertigo and visual disturbance.
Patient Data
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Hyperdense venous sinuses involving superior sagittal and right transverse sinuses.
No infarct, hemorrhage or underlying brain reaction evident on CT. No hyperdense arteries. No mass. Normal CSF configuration. Normal included bones, air spaces and extracranial soft tissues. No evidence of sinusitis/mastoiditis.
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Thrombosis confirmed on venogram; extending from superior sagittal sinus overlying motor region extending into right sigmoid sinus and included right jugular vein. The left transverse sinus and deep venous structures are patent.
Case Discussion
Extensive cerebral venous sinus thrombosis.
The patient was commenced on LMWH then warfarinised and was found to have a hypercoaguable phenotype.