Cerebral Venous Thrombosis: An Uncommon Cause of Papilledema on Bedside Ocular Ultrasound.
Acetaminophen
/ therapeutic use
Adult
Analgesics, Non-Narcotic
/ therapeutic use
Anesthetics, Local
/ therapeutic use
Cerebral Veins
/ abnormalities
Computed Tomography Angiography
/ methods
Diphenhydramine
/ therapeutic use
Dopamine Antagonists
/ therapeutic use
Female
Headache
/ etiology
Humans
Orbit
/ abnormalities
Papilledema
/ diagnosis
Prochlorperazine
/ therapeutic use
Ultrasonography
/ methods
Venous Thrombosis
/ complications
Vision Disorders
/ etiology
POCUS
cerebral venous sinus thrombosis
cerebral venous thrombosis
dural venous thrombosis
headache
intracranial hypertension
ocular ultrasound
optic nerve sheath diameter
papilledema
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
06
05
2018
revised:
19
10
2018
accepted:
25
10
2018
pubmed:
13
12
2018
medline:
16
7
2019
entrez:
13
12
2018
Statut:
ppublish
Résumé
Cerebral venous thrombosis (CVT) is a rare, difficult-to-diagnose form of venous thromboembolic disease and is considered a type of stroke. Its presentation is highly variable and may be easily confused for more common and less debilitating or life-threatening diagnoses such as migraine, seizure, or idiopathic intracranial hypertension. A 25-year-old woman presented with a complaint of bifrontal throbbing headache and blurry vision. A bedside ultrasound of the orbit suggested increased intracranial pressure. A subsequent computed tomography venogram demonstrated a left transverse sinus thrombosis. The patient was started on enoxaparin and admitted for bridging to warfarin and evaluation for hypercoagulable state. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: CVT is a rare form of stroke that carries a high rate of mortality and morbidity and masquerades as more common and benign diagnoses. Emergency department bedside ultrasound of the orbit may make the diagnosis of CVT more attainable by identifying patients with increased intracranial pressure.
Sections du résumé
BACKGROUND
BACKGROUND
Cerebral venous thrombosis (CVT) is a rare, difficult-to-diagnose form of venous thromboembolic disease and is considered a type of stroke. Its presentation is highly variable and may be easily confused for more common and less debilitating or life-threatening diagnoses such as migraine, seizure, or idiopathic intracranial hypertension.
CASE REPORT
METHODS
A 25-year-old woman presented with a complaint of bifrontal throbbing headache and blurry vision. A bedside ultrasound of the orbit suggested increased intracranial pressure. A subsequent computed tomography venogram demonstrated a left transverse sinus thrombosis. The patient was started on enoxaparin and admitted for bridging to warfarin and evaluation for hypercoagulable state. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: CVT is a rare form of stroke that carries a high rate of mortality and morbidity and masquerades as more common and benign diagnoses. Emergency department bedside ultrasound of the orbit may make the diagnosis of CVT more attainable by identifying patients with increased intracranial pressure.
Identifiants
pubmed: 30538085
pii: S0736-4679(18)31103-X
doi: 10.1016/j.jemermed.2018.10.036
pii:
doi:
Substances chimiques
Analgesics, Non-Narcotic
0
Anesthetics, Local
0
Dopamine Antagonists
0
Acetaminophen
362O9ITL9D
Diphenhydramine
8GTS82S83M
Prochlorperazine
YHP6YLT61T
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
288-293Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.