Case Report

An Unusual Presentation of Cerebral Vein Thrombosis: A 40-Year-Old Woman with Acute Intractable Cervical Pain and Lateral Neck Bending

Abstract

Cerebral venous thrombosis (CVT) is an uncommon but fatal type of stroke with a wide spectrum of signs and symptoms. We report a 40-year-old woman who presented with acute intractable neck pain and lateral cervical bending. Investigations with neuroimaging revealed evidence of thrombosis in her right transverse and sigmoid sinuses. The precipitating factors for the thrombosis were consumption of oral contraceptive pills during the month of Ramadan, and dehydration due to fasting. The patient immediately was treated with the therapeutic dose of anticoagulant. We concluded that in patients with severe cervical pain, especially those who are predisposed to thrombotic complications, CVT should be considered in the differential diagnosis.

Bousser MG, Ferro JM. Cerebral venous thrombosis: An update. Lancet Neurol 2007; 6(2): 162-70.

Siddiqui FM, Kamal AK. Complications associated with cerebral venous thrombosis. J Pak Med Assoc 2006; 56(11): 547-51.

de Bruijn SF, Stam J, Kappelle LJ. Thunderclap headache as first symptom of cerebral venous sinus thrombosis. CVST Study Group. Lancet 1996; 348(9042): 1623-5.

Brors D, Schafers M, Schick B, Dazert S, Draf W, Kahle G. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss. Neuroradiology 2001; 43(2): 144-6.

Manzano PS, Egido Herrero JA, Saiz AA, Jorquera MM. Transient ischemic attack: the only presenting syndrome of dural sinus thrombosis. Neurologia 2006; 21(3): 155-8. [In Spanish].

Wasay M, Kojan S, Dai AI, Bobustuc G, Sheikh Z. Headache in cerebral venous thrombosis: Incidence, pattern and location in 200 consecutive patients. J Headache Pain 2010; 11(2): 137-9.

Coutinho JM, Stam J, Canhao P, Barinagarrementeria F, Bousser MG, Ferro JM. Cerebral venous thrombosis in the absence of headache. Stroke 2015; 46(1): 245-7.

Kuppalli K, Livorsi D, Talati NJ, Osborn M. Lemierre's syndrome due to Fusobacterium necrophorum. Lancet Infect Dis 2012; 12(10): 808-15.

Akashi Y, Shiigai M, Suzuki H. Septic Thrombosis of the Internal Vertebral Venous Plexus: A rare cause of neck pain. J Gen Fam Med 2015; 16(4): 307-8.

Kuehnen J, Schwartz A, Neff W, Hennerici M. Cranial nerve syndrome in thrombosis of the transverse/sigmoid sinuses. Brain 1998; 121 (Pt 2): 381-8.

Misra UK, Kalita J, Bansal V. D-dimer is useful in the diagnosis of cortical venous sinus thrombosis. Neurol India 2009; 57(1): 50-4.

Saposnik G, Barinagarrementeria F, Brown RD, Jr., Bushnell CD, Cucchiara B, Cushman M, et al. Diagnosis and management of cerebral venous thrombosis: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011; 42(4): 1158-92.

Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: Results of the

International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004; 35(3): 664-70.

Dentali F, Crowther M, Ageno W. Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: A meta analysis. Blood 2006; 107(7): 2766-73.

Jick SS, Jick H. Cerebral venous sinus thrombosis in users of four hormonal contraceptives: Levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch. Contraception 2006; 74(4): 290-2.

Files
IssueVol 3 No 1 (2018): Winter QRcode
SectionCase Report(s)
Keywords
Venous thrombosis Neck pain Oral contraceptives Cranial sinuses

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Kalantar SS, Amrzargar N, Ranji Burachaloo S. An Unusual Presentation of Cerebral Vein Thrombosis: A 40-Year-Old Woman with Acute Intractable Cervical Pain and Lateral Neck Bending. CRCP. 2018;3(1):30-34.