Cerebral Venous Thrombosis

Another headache

Step 1: View clinicals

A 49 year old man presents following a generalized tonic-clonic seizure of 2 minutes duration. He also complains of weakness of the left side since waking up today. He had a persistent headache for the last 2 weeks, which was worse upon waking up and coughing. His medical history is otherwise unremarkable.


Step 2: Order all relevant investigations

Full Blood Count

WBC/DC: 6,000/mm3 N: 65%, L: 30% Hb: 13.5 g/dl PCV: 39 % Platelets: 256,000/mm3

CT Brain

The CT scan of the brain appears normal.

MRI + MRV Brain

T1 weighted MRI imaging shows an abnormal high signal in the superior sagittal sinus, while MRV shows absence of flow in the same region.

Lumbar Puncture

A lumbar puncture will be arranged tomorrow.


Step 3: Select appropriate management

Antiepileptic drugs
Anticoagulation
Antibiotics
Steroids


Score: ★★☆