Open AccessA young woman with headache and seizures
Author(s) -
Attila M. Pizzini,
Mauro Silingardi,
Ivan Iori
Publication year - 2013
Publication title -
italian journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.134
H-Index - 10
eISSN - 1877-9352
pISSN - 1877-9344
DOI - 10.4081/itjm.2008.4.25
Subject(s) - medicine , thrombophilia , warfarin , venous thrombosis , thrombosis , radiology , thrombolysis , neuroimaging , past medical history , medical history , physical examination , pediatrics , angiography , surgery , atrial fibrillation , psychiatry , myocardial infarction
CASE REPORT We describe a 31 year-old woman with headache and acute onset of seizures. Medical history and physical examination were unremarkable. She has been on therapy with oral contraceptives for many years for dysmenorrhea. A CT scan was negative, but MRI and MR-angiography showed left transverse sinus thrombosis. Screening for thrombophilia revealed hyperhomocysteinemia and Factor V Leiden heterozigousity. The patient received unfractionated heparin, followed by long-term anticoagulation with warfarin (INR 2-3). CONCLUSIONS Cerebral venous thrombosis is a rare cerebrovascular disorder, frequently in young adult (about 75% are women). The diagnosis might be difficult with consequent high long-term morbidity and mortality rate. New neuroimaging techniques (MRI and MR-angiography) and more effective treatment (anticoagulation and endovascular thrombolysis) have improved the prognosis and the natural history. The risk factors, the clinical presentation, the diagnostic evaluation and the management of cerebral venous thrombosis are reviewed