A Case of Cerebral Venous Sinus Thrombosis Presenting with Delirium

  • Mahnaz Pejman Sani Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mahbube Ebrahimpur Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract

A 73-year-old woman with no history of headache, seizure and trauma was admitted to the emergency department complaining about fever, vomiting and delirium for 3 days. She was lethargic upon admission and her blood pressure (BP) was recorded as 140/90 mm/Hg, her pulse rate (PR) as 75 beat/min and oral temperature as 38 °C. No localizing findings were observed in neurological examinations.  Laboratory findings were as follows:  White Blood Cell (WBC) count: 7,000/mm3, Hemoglobin: 13 g/dl, Platelet count: 300000. Lumbar CSF, blood and urine cultures were found to be negative for infections. Brain Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) were also performed. MRI showed filling defects in the left transverse sinus, the jugular bulb and the internal jugular vein. Moreover, hyper-intense signal was observed in the left temporal lobe (T1 sequence) suggesting hemorrhagic venous infarction (Figure1). The obtained results were confirmed by Magnetic Resonance Venography (MRV) of the brain (Figure2). The patient underwent anticoagulation therapy using LMWH and she was? hydrated using physiologic solution. The patient’s symptoms disappeared and she was then followed up regularly.

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References

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Published
2018-10-01
How to Cite
Pejman Sani, M., & Ebrahimpur, M. (2018). A Case of Cerebral Venous Sinus Thrombosis Presenting with Delirium. Advanced Journal of Emergency Medicine, 3(1), e11. https://doi.org/10.22114/ajem.v0i0.113
Section
Case based learning points