Publications

Abstract

Cerebral venous thrombosis (CVT) is an important form of stroke in India that if missed can lead to therapeutic mismanagement and devastating consequences whereas recognition typically follows with good prognosis. Predominantly occurring in younger patients, known associations include dehydration, the peri-partum period, infection, other hypercoagulable states and risk factors such as alcohol and OCP use. Unrecognized CVT may result in neurologic impairment, recurrence, brain oedema and herniation. However, at onset, CVT often lacks classic signs, as with arterial stroke. While neurologic signs may present, non-specific signs and symptoms are most common, making consideration of CVT in the differential diagnosis critical in the emergency setting. A 43-year-old patient presented to our department with an acute progression of a headache, nausea, vomiting, hemiparesis and unresponsiveness. Despite initial symptom relief, her worsening condition and altered mental status (AMS) prompted hospital arrival. History was significant only for levothyroxine for hypothyroidism and long-term OCP use for dysmenorrhoea. Brain MRI diagnosed CVT, initiating treatment. During recovery, further possible underlying causes were investigated. Recognition and appropriate referral for CVT are crucial for managing outcomes and addressing causes. Knowledge of risk factors and an index of suspicion when evaluating younger adults can prevent oversight of this critical diagnosis.