Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Case Report
4 (
2
); 193-196
doi:
10.4103/0976-3147.112767

Reversible diencephalic dysfunction as presentation of deep cerebral venous thrombosis due to hyperhomocysteinemia and protein S deficiency: Documentation of a case

Department of Neurology, Command Hospital, Alipore, Kolkata, India
Address for correspondence: Col K M Hassan Department of Neurology, Command Hospital Alipore, Kolkata ‑ 700 027 India kaukabm.hassan@gmail.com
Licence
This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

ABSTRACT

A 45‑year‑old man presented with global headache, vomiting and abnormal behavior after cross‑country run at high altitude. There was no seizure, loss of consciousness, fever or head injury. He was conscious, abulic and uncooperative with normal vitals. There was no focal neurological deficit. Non contrast computed tomography scan of head was normal. Magnetic resonance imaging of brain showed venous infarct in bilateral thalami, left basal ganglia and periventricular white matter. Magnetic resonance venography revealed thrombosis involving internal cerebral veins, septal veins, thalamostriate veins, vein of Galen and proximal portion of straight sinus. His condition steadily improved on low molecular weight heparin bridged with oral anticoagulation for one year. At two months, serum homocysteine was 31.51 μmol/l (5.46‑16.2 μmol/l) and protein S was 49.00% (77‑143.00%). He received methylcobalamin, pyridoxine and folic acid. After 16 months, he was asymptomatic with partially recanalized deep cerebral veins and serum homocysteine falling to 16.50 μmol/l (5.46‑16.2 μmol/l).

Keywords

Deep cerebral venous thrombosis
headache
hyperhomocysteinemia
protein S deficiency
vasogenic edemae

Conflict of Interest

None declared

References

  1. , , . Cerebral venous thrombosis: An update. Lancet Neurol. 2007;6:162-70.
    [Google Scholar]
  2. , , , , , . Hyperhomocysteinemia in cerebral vein thrombosis. Blood. 2003;102:1363-6.
    [Google Scholar]
  3. , , , , , , . Hyperhomocysteinemia and other newly recognized inherited coagulation disorders (factor V leiden and prothrombin gene mutation) in patients with idiopathic cerebral vein thrombosis. Cerebrovasc Dis. 2004;17:153-9.
    [Google Scholar]
  4. , , , . Acute medical problems in the Himalayas outside the setting of altitude sickness. High Alt Med Biol. 2000;1:167-74.
    [Google Scholar]
  5. , , , , , . Endovascular thrombolysis in deep cerebral venous thrombosis. AJNR Am J Neuroradiol. 1997;18:502-6.
    [Google Scholar]
  6. , , , , , , et al . Diagnosis and Management of Cerebral Venous Thrombosis: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011;42:1158-92.
    [Google Scholar]
  7. , , , , , . Deep cerebral venous thrombosis: An illustrative case with reversible diencephalic dysfunction. Can J Neurol Sci. 2001;28:159-63.
    [Google Scholar]
  8. , , , , , . Thrombosis of the deep venous drainage of the brain in adults: Analysis of seven cases with review of the literature. Arch Neurol. 1995;52:1101-8.
    [Google Scholar]
  9. , , . Cerebral venous thrombosis. Ann Indian Acad Neurol. 2008;11:S79-87.
    [Google Scholar]
  10. , , , . Cerebral venous thrombosis due to protein S deficiency in pregnancy. Lancet. 2002;359:892.
    [Google Scholar]
  11. , , , , . Diffusion-and perfusion-weighted magnetic resonance imaging in deep cerebral venous thrombosis. Stroke. 1999;30:1144-6.
    [Google Scholar]
  12. , , , . Local thrombolytic therapy in deep cerebral venous thrombosis. Neurology. 1997;48:1613-9.
    [Google Scholar]

Fulltext Views
360

PDF downloads
214
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections