Titel | Cerebral venous sinus thrombosis: insidious presentation with papilloedema |
Abstract Nr. | 1039 |
Doel | To report a case of cerebral venous sinus thrombosis (CVST) with an insidious presentation. |
Methodes | A 17-year-old male of mixed European and African ethnicity presented with headaches and bilateral papilloedema since one month. Work-up included basic ophthalmological examination, visual field testing, VEP and cerebral MRI venography (MRV). |
Resultaten | The patient described fluctuating throbbing frontal headaches since 1 month, associated with a pulsatile tinnitus in the left ear. A diagnosis of otitis media was suspected in Senegal and Docycycline was initiated, without resolution of symptoms. Ophthalmological examination showed bilateral papilloedema, however cerebral MRI in Senegal showed no abnormalities. The patient presented at our policlinic for a second opinion. BCVA, biomicroscopy and IOP were normal. Fundus examination confirmed bilateral papilloedema and visual field examination showed an enlarged blind spot at the RE. Pattern VEP showed bilateral prolonged latencies with normal amplitudes. MRV revealed thrombosis of the distal superior sagittal sinus with extension into the right transverse sinus. Therapeutic LMW-heparin was initiated. Neurologic examination and thrombophilia screening were normal. After 1 week the headaches had disappeared and after 1 month MRI showed a decrease in thrombus volume. |
Conclusie | Although infrequent in young healthy males, this case highlights the importance of considering CVST in the differential diagnosis of papilloedema. MRI combined with MRV is currently the best method to confirm the diagnosis of CVST. |
Naam | ROELS |
Initialen | D |
Instituut | Dpt of Ophthalmology, Ghent University Hospital |
Stad | Ghent |
Naam | VERLOO |
Initialen | P |
Instituut | Dpt of Pediatric Neurology, Ghent University Hospital |
Stad | Ghent |
Naam | DEBLAERE |
Initialen | K |
Instituut | Dpt of Neuroradiology, Ghent University Hospital |
Stad | Ghent |
Naam | DELBEKE |
Initialen | P |
Instituut | Dpt of Ophthalmology, Ghent University Hospital |
Stad | Ghent |