A rare case of chronic headache

Abstract

Abstract Cerebral venous thrombosis (CVT) is a relatively uncommon and rare condition worldwide, affecting approximately 1 in 100,000 individuals annually and comprising about 0.5% of all strokes. It is more prevalent in women of childbearing age due to hypercoagulable states. We present a case report of a 19 years old female exhibiting symptoms, including headache, occasionally associated vomiting, blurring of vision and one generalised seizure. On general examination and neurological, there were no significant abnormality found, Fundoscopy revealed blurred disc margins and the presence of papilledema. An emergency non-contrast computed tomography (NCCT) scan of the brain showed normal findings. Subsequently, a magnetic resonance imaging (MRI) scan of the brain indicated partial loss of flow void in the posterior part of the superior sagittal sinus and straight sinus, along with the formation of collateral channels, suggestive of possible subacute dural sinus thrombosis. Additionally, a contrast-enhanced MRI (CEMRI) scan with MR venogram showed filling defects in the posterior part of the superior sagittal sinus and straight sinus, with non-visualization of the left transverse sinus, indicative of subacute to chronic dural venous thrombosis, Beta 2 glycoprotein IgM and Cardiolipin IgM were positive and titres were high. This case with history of headache for 4 years underscores the need for early diagnosis, which could have alleviated suffering and further prevent grave consequences, with an insight to such problems and accessibility to high end imaging diagnosis tools for early recognition and management.