Obstructive Hydrocephalus from Venous Sinus Thrombosis |
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Authors: | Michael T Mullen Lauren H Sansing Robert W Hurst John B Weigele Rajeev S Polasani Steven R Messé |
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Affiliation: | (1) Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19103, USA;(2) Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19103, USA |
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Abstract: | Background Cerebral venous sinus thrombosis (CVST) is a rare form of stroke. Although increased intracranial pressure is a well-described
complication of CVST, hydrocephalus has rarely been reported.
Case We present the case of a 49-year-old woman who presented with one week of headache, vomiting, and progressive neurologic deterioration
leading to coma. Head CT and MRI identified extensive CVST and accompanying hydrocephalus. She was treated with systemic anticoagulation
as well as mechanical and pharmacologic endovascular thrombolysis. An external ventricular drain (EVD) was not inserted given
the potential bleeding risk while anticoagulated. Subsequently, she made an excellent recovery and had a normal neurologic
exam at long-term follow up.
Conclusion Hydrocephalus is a rare complication of cerebral venous sinus thrombosis. Treatment of hydrocephalus with an EVD may not be
necessary if interventions are undertaken to urgently recanalize thrombosed venous sinuses. |
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Keywords: | Venous sinus thrombosis Hydrocephalus Endovascular thrombolysis Mechanical thrombolysis Venous infarction |
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