Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis

A 36-year-old female patient had headache and generalized tonic-clonic seizure. Due to headache, nausea, facial twitching, difficulty in swallowing, contraction of jaw, anemiadand generalized tonic convulsion the patient hadundergone cranial computed tomography (CT) and magnetic resonance (MR) venog...

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Main Authors: Cem Ece, Şeyda Canlı, Fatih Balaban, Deniz Aslan, Duygu Engin
Format: Article
Language:English
Published: Galenos Yayinevi 2022-03-01
Series:Türk Yoğun Bakim Derneği Dergisi
Subjects:
Online Access: http://www.turkishjic.org/archives/archive-detail/article-preview/case-report-a-rare-cause-of-schemic-stroke-in-the-/49781
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author Cem Ece
Şeyda Canlı
Fatih Balaban
Deniz Aslan
Duygu Engin
author_facet Cem Ece
Şeyda Canlı
Fatih Balaban
Deniz Aslan
Duygu Engin
author_sort Cem Ece
collection DOAJ
description A 36-year-old female patient had headache and generalized tonic-clonic seizure. Due to headache, nausea, facial twitching, difficulty in swallowing, contraction of jaw, anemiadand generalized tonic convulsion the patient hadundergone cranial computed tomography (CT) and magnetic resonance (MR) venography. The results were found to be consistent with venous infarction and encephalitis in the right temporoparietal region. The patient was administered low molecular weight heparins, antiepileptic medication, acyclovir and ceftriaxone. On the second day, the patient’s tendency to sleep increased and hemiparesis developed in the left upper and lower extremities. The superior sagittal sinus is most commonly affected in venous sinus thrombosis (VST). Symptoms may vary depending on the localization of the thrombosis. Headache, increased intracranial pressure findings, epileptic seizures and focal neurological disorders are the most common clinical findings. In addition to clinical findings, CT, contrast-enhanced MR imaging and MR venography are used in the diagnosis of VST. Oral contraceptive (OCS) use in individuals with genetic risk, labor or a penetrating trauma event may induce VST. It has been shown that there may be a relationship between iron deficiency anemia and VST, especially if the hemoglobin value is below 9 g/dL, which increases the risk of VST. Kidney failure, hypothyroidism, smoking and high homocysteine level are among the other factors that are accused. Treatment of VST should be started immediately. Treatment should be directed towards the primary cause leading to anticoagulation and clinical VST. The ability of venous thrombosis to respond to anticoagulant treatment makes it important to start treatment early. We think that it is important to investigate VST with imaging methods, especially in cases where there are predisposing factors such as pregnancy and OCS use.
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spelling doaj.art-02261b1f279e48039f334a8cea606a072023-02-15T16:11:31ZengGalenos YayineviTürk Yoğun Bakim Derneği Dergisi2146-64162147-267X2022-03-01201566010.4274/tybd.galenos.2021.8077413049054Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus ThrombosisCem Ece0Şeyda Canlı1Fatih Balaban2Deniz Aslan3Duygu Engin4 İzmir Tınaztepe Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Anestezi Bölümü; İzmir Tınaztepe Galen Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İzmir, Türkiye İzmir Tınaztepe Galen Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İzmir, Türkiye İzmir Tınaztepe Galen Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İzmir, Türkiye İzmir Tınaztepe Galen Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İzmir, Türkiye İzmir Tınaztepe Galen Hastanesi, Radyoloji Kliniği, İzmir, Türkiye A 36-year-old female patient had headache and generalized tonic-clonic seizure. Due to headache, nausea, facial twitching, difficulty in swallowing, contraction of jaw, anemiadand generalized tonic convulsion the patient hadundergone cranial computed tomography (CT) and magnetic resonance (MR) venography. The results were found to be consistent with venous infarction and encephalitis in the right temporoparietal region. The patient was administered low molecular weight heparins, antiepileptic medication, acyclovir and ceftriaxone. On the second day, the patient’s tendency to sleep increased and hemiparesis developed in the left upper and lower extremities. The superior sagittal sinus is most commonly affected in venous sinus thrombosis (VST). Symptoms may vary depending on the localization of the thrombosis. Headache, increased intracranial pressure findings, epileptic seizures and focal neurological disorders are the most common clinical findings. In addition to clinical findings, CT, contrast-enhanced MR imaging and MR venography are used in the diagnosis of VST. Oral contraceptive (OCS) use in individuals with genetic risk, labor or a penetrating trauma event may induce VST. It has been shown that there may be a relationship between iron deficiency anemia and VST, especially if the hemoglobin value is below 9 g/dL, which increases the risk of VST. Kidney failure, hypothyroidism, smoking and high homocysteine level are among the other factors that are accused. Treatment of VST should be started immediately. Treatment should be directed towards the primary cause leading to anticoagulation and clinical VST. The ability of venous thrombosis to respond to anticoagulant treatment makes it important to start treatment early. We think that it is important to investigate VST with imaging methods, especially in cases where there are predisposing factors such as pregnancy and OCS use. http://www.turkishjic.org/archives/archive-detail/article-preview/case-report-a-rare-cause-of-schemic-stroke-in-the-/49781 sinus vein thrombosisstrokeintensive care
spellingShingle Cem Ece
Şeyda Canlı
Fatih Balaban
Deniz Aslan
Duygu Engin
Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis
Türk Yoğun Bakim Derneği Dergisi
sinus vein thrombosis
stroke
intensive care
title Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis
title_full Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis
title_fullStr Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis
title_full_unstemmed Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis
title_short Case Report: A Rare Cause of Ischemic Stroke in the Intensive Care Unit: Venous Sinus Thrombosis
title_sort case report a rare cause of ischemic stroke in the intensive care unit venous sinus thrombosis
topic sinus vein thrombosis
stroke
intensive care
url http://www.turkishjic.org/archives/archive-detail/article-preview/case-report-a-rare-cause-of-schemic-stroke-in-the-/49781
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AT fatihbalaban casereportararecauseofischemicstrokeintheintensivecareunitvenoussinusthrombosis
AT denizaslan casereportararecauseofischemicstrokeintheintensivecareunitvenoussinusthrombosis
AT duyguengin casereportararecauseofischemicstrokeintheintensivecareunitvenoussinusthrombosis