A RARE PRESENTATION OF CEREBRAL VENOUS SINUS THROMBOSIS AS SUBARACHNOID HAEMORRHAGE
Abstract
Previously ,Subarachnoid Haemorrhage
(SAH) is most often due to aneurysmal
rupture.Other vascular lesions are known
to rarely cause SAH.Cerebral venous sinus
thrombosis(CVT) can be difficult to
diagnose because of its wide spectrum
of clinical manifestations.Its diagnosis
can be further complicated when patients
initially present with acute SAH.We report
a rare presentation of CVT as
SAH.We report a case of 40years old female
patient presented with acute onset
of severe headache with vomiting.
Computerised Tomography(CT) contrast
brain showed SAH in the basal cistern.
Digital Subtraction Angiography
(DSA)was done to detect the cause of
SAH which was normal.Magnetic Resonance
Imaging(MRI) of brain was done
which showed thrombus in the superior,
inferior sagital sinuses,Transverse
sinus and sigmoid sinus on both
sides.Patient improved with anticoagulant
therapy.This case highlights the fact
that SAH may reveal a CVT,
and emphasizes on the inclusion of Magnetic
Resonance Venography(MRV) in the
diagnostic workup of SAH,particularly in
cases in which aneurysm is not detected.
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Oppenheim C, Domigo V, Gauvrit JY,
Lamy C, Mackowiak-Cordoliani MA,
Pruvo JP, et al. Subarachnoid hemorrhage
as the initial presentation of dural
sinus thrombosis. AJNR Am J Neuroradiol.
;26:614–7.
Sztajzel R, Coeytaux A, Dehdashti
AR, Delavelle J, Sinnreich M. Subarachnoid
hemorrhage: A rare presentation of
c e r e b r a l v e n o u s t h r o m b o -
sis. Headache. 2001;41:889–92.
Chang R, Friedman DP. Isolated
cortical venous thrombosis presenting
as subarachnoid hemorrhage: A
report of three cases. AJNR Am J
Neuroradiol. 2004;25:1676–9.
Lin JH, Kwan SY, Wu D. Cerebral
venous thrombosis initially presenting
with acute subarachnoid hemorr
h a g e . J C h i n M e d
Assoc. 2006;69:282–5.
Spitzer C, Mull M, Rohde V, Kosinski
CM. Non-traumatic cortical subarachnoid
haemorrhage: diagnostic
work-up and aetiological background.
Neuroradiology. 2005;47:52
–31.
Cuvinciuc V, Viguier A, Calviere L,
Raposo N, Larrue V, Cognard C, et
al. Isolated Acute Nontraumatic Cortical
Subarachnoid Hemorrhage.
AJNR Am J Neuroradiol.
Pradhan S, Yadav R, Diwakar H,
Phadke RV. Subarachnoid hemorrhage
following chronic dural venous
sinus thrombosis Angiology.
;58:498–501.
van Gijn J, Rinkel GJ. Subarachnoid
haemorrhage: Diagnosis,
causes and management. Brain.
;124:249–78.
Warlow CP, Dennis MS, Van Gijn
J. Stroke: A practical guide to management.
Blackwell Science.
:376–413.
Wang YF, Fuh JL, Lirng JF,
Chang FC, Wang SJ. Spontaneous
intracranial hypotension with isolated
cortical vein
thrombosis and subarachnoid haemorrhage.
Cephalalgia. 2007;27:1413–7.
de Bruijn SF, Budde M, Teunisse S,
de Haan RJ, Stam J. Long-term outcome
of cognition and functional health after
cerebral venous sinus thrombosis.
Neurology. 2000;54:1687–9.
Biondi A, Casasco A, Houdart E, Gioino
C, Sourour N, Vivas E, et al. Evolution
of angiographic signs of venous hypertension
and clinical signs of intracranial
hypertension in intracranial dural arteriovenous
fistulas. J Neuroradiol.
;26:49–58.
Einhäupl KM, Villringer A, Meister W,
Mehraein S, Garner C, Pellkofer M,
Haberl RL, et al. Heparin treatment in
s i n u s v e n o u s t h r o m b o -
sis. Lancet. 1991;338:597–600.
de Bruijn SF, Stam J. Randomized,
placebo-controlled trial of anticoagulant
treatment with low-molecular-weight
heparin for cerebral sinus thrombosis.
Stroke. 1999;30:484–8.
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