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Deze abstract is toegekend aan sessie AOB Poster session1
TitelCerebral venous sinus thrombosis: insidious presentation with papilloedema
Abstract Nr.1039
DoelTo report a case of cerebral venous sinus thrombosis (CVST) with an insidious presentation.
MethodesA 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).
ResultatenThe 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.
ConclusieAlthough 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.
Auteur 1
NaamROELS
InitialenD
InstituutDpt of Ophthalmology, Ghent University Hospital
StadGhent
Auteur 2
NaamVERLOO
InitialenP
InstituutDpt of Pediatric Neurology, Ghent University Hospital
StadGhent
Auteur 3
NaamDEBLAERE
InitialenK
InstituutDpt of Neuroradiology, Ghent University Hospital
StadGhent
Auteur 4
NaamDELBEKE
InitialenP
InstituutDpt of Ophthalmology, Ghent University Hospital
StadGhent
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