[Cerebral sinus thrombosis in Behçet disease: case report and review of the literature].
BACKGROUND
Behçet's disease is a chronic inflammatory disorder, clinically characterised by multisystemic vasculitis. Primary neurologic involvement in childhood is quite exceptional. We report a case of a child with recurrent venous thrombosis of the dural sinus. Behçet's disease was diagnosed.


METHODS
A 13-year-old boy from Eritrea was referred to our clinic with severe headaches and photophobia one month after onset. Ophthalmological examination disclosed a bilateral papilledema. Recurrent oral ulcers and pseudo-folliculitis were present. Pathergy test was positive.


RESULTS
Complementary investigations disclosed an inflammatory syndrome. Computertomography was normal. Cranial magnetic resonance venography disclosed multiple cerebral sinus thrombosis (superior sagittal sinus, sigmoid sinus and lateral left sinus). There was no evidence of infectious, inflammatory or hypercoagulation disorder. A Behçet's disease was diagnosed based on the medical history and clinical examination. Whilst his general health deteriorated rapidly before treatment, he improved quickly after the onset of therapy with immunosuppression (Prednisone and Ciclosporine) in combination with anticoagulation (coumarin/Sintrom).


CONCLUSIONS
Behçet's disease is uncommon and difficult to diagnose in children. Neurologic involvement as a first presentation is rarely described, but might be underestimated. We emphasise, therefore, the systematic application of magnetic resonance venography in children with unclear persistent headaches.
Chaloupka
Karla
K
Clinique d'Ophtalmologie, Département de neurosciences cliniques, Hôpitaux Universitaires de Genève, Genève, Suisse. Karla.Chaloupka@hcuge.ch
Baglivo
Edoardo
E
Hofer
Michael
M
Chizzolini
Carlo
C
Delavelle
Jacqueline
J
Rossillion
Béatrice
B
Safran
Avinoam B
AB
D000293:Adolescent; D000925:Anticoagulants / Q000008:administration & dosage; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016572:Cyclosporine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D018810:Magnetic Resonance Angiography; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
D000925:Anticoagulants; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone