An unusual case of cerebral venous sinus thrombosis in a pediatric patient.
BACKGROUND
Cerebral venous sinus thrombosis (CVST) is a rare, but potentially devastating illness. It is important for emergency physicians to be aware of the classic and most common risk factors leading to this illness, including genetic and acquired prothrombotic states, infection, inflammatory conditions, and certain drugs.


OBJECTIVE
The objectives of this article are to discuss a case of CVST and describe the signs and symptoms of CVST as well as the radiologic modalities used to diagnose this disease. Finally, we will discuss the causes and risk factors that lead to this potentially devastating diagnosis.


METHODS
An 11-year-old girl was found unconscious and without pulses in an apparent drug overdose. Emergency Medical Services responders and Emergency Department personnel resuscitated the patient to a return of spontaneous circulation. The patient was intubated and admitted to the intensive care unit. As part of an altered mental status work-up, a magnetic resonance imaging scan of the head was performed and showed a cerebral venous sinus thrombosis. This was thought to be due to the drug overdose and the low-flow state that occurred during loss of circulation. After anticoagulation therapy and antibiotic treatment for sinusitis, the patient had a full recovery.


CONCLUSIONS
Rapid diagnosis of CVST was essential to the appropriate care of this patient. Being aware of signs, symptoms, and risk factors leading to CVST will assist the emergency physician in making this diagnosis.
Moore
William N
WN
Department of Emergency Medicine, Wake Forest University Health Sciences, Winston Salem, North Carolina 27157, USA.
Cannon
Michael L
ML
O'Neill
James C
JC
D000925:Anticoagulants / Q000008:administration & dosage; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002648:Child; D003422:Critical Care / Q000379:methods; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D004632:Emergency Medical Services; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007362:Intensive Care Units; D008279:Magnetic Resonance Imaging / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014474:Unconsciousness / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin