Obstructive hydrocephalus from venous sinus thrombosis.
BACKGROUND
Cerebral venous sinus thrombosis (CVST) is a rare form of stroke. Although increased intracranial pressure is a well-described complication of CVST, hydrocephalus has rarely been reported.


METHODS
We present the case of a 49-year-old woman who presented with one week of headache, vomiting, and progressive neurologic deterioration leading to coma. Head CT and MRI identified extensive CVST and accompanying hydrocephalus. She was treated with systemic anticoagulation as well as mechanical and pharmacologic endovascular thrombolysis. An external ventricular drain (EVD) was not inserted given the potential bleeding risk while anticoagulated. Subsequently, she made an excellent recovery and had a normal neurologic exam at long-term follow up.


CONCLUSIONS
Hydrocephalus is a rare complication of cerebral venous sinus thrombosis. Treatment of hydrocephalus with an EVD may not be necessary if interventions are undertaken to urgently recanalize thrombosed venous sinuses.
Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19103, USA. Michael.Mullen@uphs.upenn.edu.
Michael T
MT
Mullen
Lauren H
LH
Sansing
Robert W
RW
Hurst
John B
JB
Weigele
Rajeev S
RS
Polasani
Steven R
SR
Messé
D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy