Presentation
Headache and vomiting after surgery for thrombosed hemorrhoids. History of ulcerative colitis with verified congenital hypercoagulable condition.
Patient Data
Thrombosis of the right transverse and sigmoid sinus, straight sinus and vein of Galen. Partial thrombosis of the left transverse sinus, superior sagittal sinus and right jugular bulb.
No morphological or functional changes in brain parenchyma.
Case Discussion
Patient surpassed TIA with right-sided hemiparesis in the past, with diagnosis of homozygous mutation in MTHFR (Methylene tetrahydrofolate reductase). The MTHFR gene produces an enzyme that helps regulate homocysteine levels in the body. Disorders in homocystein metabolism are associated with increased risk of vein thrombosis and are connected with vascular wall damage. The exact connection and mechanisms are still not well known.