Complicated cerebral venous sinus thrombosis with intracranial hemorrhage and mastoiditis.
Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke, occurring when a blood clot forms in any of the brain venous sinuses. Symptoms include neurological deficits, headache, seizures, and coma. There are many predisposing factors for CVST including prothrombotic conditions, oral contraceptives, pregnancy/puerperium, malignancy, infection, and head injury. Cerebral venous sinus thrombosis has no identifiable underlying etiology in about 12.5% to 33% of the cases. Diagnosis has become easier with newer imaging techniques, such as magnetic resonance venography. The treatment options for CVST include symptomatic treatment, anticoagulation (AC), thrombolysis, and thrombectomy. Controversy exists over the efficacy and safety of AC in patients with CVST with concurrent intracranial hemorrhage (ICH). We present a complex case of CVST with ICH and mastoiditis as well as provide a literature review about CVST.
Vascular Medicine, Abbott Northwestern Hospital/Minneapolis Heart Institute, Minneapolis, MN 55407, USA.
Nedaa
N
Skeik
Madeline M
MM
Stark
David E
DE
Tubman
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects; D002533:Cerebral Angiography / Q000379:methods; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D008417:Mastoiditis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D010690:Phlebography / Q000379:methods; D011237:Predictive Value of Tests; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017131:Thrombectomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000925:Anticoagulants