Cerebral Venous Sinus Thrombosis: A Case Report with Review of Diagnosis and Treatment Strategies

Abstract

Cerebral venous sinus thrombosis (CVST) is an often under-diagnosed, life-threatening condition. We report the case of a 17-year-old female who presented with an acute, severe, on-going, headache. The initial head CT was negative. While the patient’s headache initially responded to pain medication and inpatient treatment, the patient subsequently developed left-sided neurological deficits. Subsequent imaging showed thrombosis in the superior sagittal sinus. The patient was treated with Lovenox, as well as thrombolysis using TPA, ballooning and mechanical removal, and soon after her neurological deficits resolved and her headache severity had significantly decreased. The aim of this case report is to provide an example of how early suspicion of CVST, even with initial negative imaging, is critical, as any delay in diagnosis and treatment can cause increased morbidity and mortality