title: Cerebral venous sinus thrombosis presenting as transient ischemic attacks in a case with homozygous mutations of MTHFR A1298C and CG677T.
abstract: We report a case with recurrent, transient attacks of slurred speech, weakness, and numbness of the right half of the face and the right arm without seizure activity, accompanied by headache and double vision. Neurologic examination revealed bilateral papilledema and right abducens palsy. Brain magnetic resonance imaging revealed thrombosis of the dural venous sinuses and the cortical veins, with no evidence of parenchymal lesion. Homozygous mutations were found for methylenetetrahydrofolate reductase (MTHFR) A1298C and MTHFR CG677T. Anticoagulation with heparin and warfarin resulted in prompt cessation of the transient attacks, as well as the signs and symptoms of increased intracranial pressure. This report documents that, although rare, transient ischemic attacks can result from cerebral venous thrombosis.
authors.affiliation: Department of Neurology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey. ozlemkayim@yahoo.com
authors.forename: Ozlem Kayim
authors.initials: OK
authors.lastname: Yildiz
authors.forename: Seyda
authors.initials: S
authors.lastname: Cevik
authors.forename: Gulsum
authors.initials: G
authors.lastname: Cil
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Oztoprak
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Bolayir
authors.forename: Suat
authors.initials: S
authors.lastname: Topaktas
mesh_terms: D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D006720:Homozygote; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000201:enzymology* / Q000235:genetics*; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000172:deficiency / Q000235:genetics*; D017354:Point Mutation / Q000235:genetics*; D011859:Radiography; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000201:enzymology* / Q000235:genetics*; D055815:Young Adult
chemical_list: D042965:Methylenetetrahydrofolate Reductase (NADPH2)