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2016 ; 6
(5
): 32361
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Throbbing headache is not always migraine; it can be serious
#MMPMID27802851
Meseeha MG
; Attia M
J Community Hosp Intern Med Perspect
2016[]; 6
(5
): 32361
PMID27802851
show ga
Cerebral venous thrombosis (CVT) is a rare but serious venous thrombotic disorder
in the general population. It has an estimated annual incidence of about 4-5
cases per 1 million persons. It is more common in females than males. We describe
below a case of a 49-year-old female patient who presented to the emergency room
with 1 day history of right-sided throbbing headache associated with vomiting.
Computed tomography (CT) scan of the head without contrast showed venous sinus
thrombosis involving the posterior sagittal sinus, extending into the dominant
right transverse sinus, which was confirmed by CT head with intravenous contrast.
The patient was immediately started on anticoagulation with therapeutic
low-molecular-weight heparin that was transitioned to warfarin. Follow-up CT head
3 months later showed resolution of the thrombus and recanalization of the
affected veins. A high level of suspicion for a rare disorder like CVT should be
considered as part of the differential diagnosis of headache, which is a commonly
encountered problem, because immediate anticoagulation treatment can prevent
fatal complications.