Clinical analysis and misdiagnosis of cerebral venous thrombosis

Abstract

The present study aimed to summarize the clinical characteristics and experiences of misdiagnoses of cerebral venous thrombosis (CVT). A total of 18 patients with CVT who received treatment between September 2009 and August 2011 were enrolled. Of the patients, 13 were females and 5 were males with an average age of 39 years. Clinical manifestations and characteristics according to cerebrospinal fluid examination and imaging were summarized retrospectively. CVT principally manifested as headaches, papilledema, psychiatric symptoms, impaired consciousness and seizure disorders, with or without neurological defects. A combination of magnetic resonance imaging (MRI) and venography (MRV) was demonstrated to be an effective method for CVT diagnosis. Of the 18 patients, 8 were misdiagnosed, as a result of the lack of further examination due to undefined etiology, atypical clinical manifestations and ambiguous neuroimaging direct signs. The clinical symptoms of CVT are aspecific, as a result of which misdiagnosis tends to occur. For patients with intracranial hypertension accompanied with or without neurological defects, MRI combined with MRV can improve the accuracy of CVT diagnosis.

Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

“…It is a rare but serious disorder, and at a high altitude this disorder is reported meagerly [2, 3]. Very few cases are diagnosed for various reasons and due to the lack of numerous analogous cases; this disorder can often be misdiagnosed [4, 5]. In Nepal, increased awareness of this condition amongst physicians and availability of investigation facility in recent years have led to early diagnosis and favorable outcome in patients with CVST.…”

Seizure in cerebral venous and sinus thrombosis

“…Primary prophylactic antiepileptic treatment has been suggested by a few studies . Other reports have recommended initiation of treatment after one or two seizures in the acute phase in patients with specific findings on neurological examination and neuroimaging . Data regarding duration of treatment and the best type and dosage of AEDs in the acute phase are also controversial .…”

Chronic disorders of consciousness

“…Traumatic brain injury-related mortality has reduced from 17% in 2000 to 11% in 2010, as reported by Siman-Tov, et al (1). However, 10-15% of patients who sustain severe acquired brain injury enter a condition termed a disorder of consciousness (DOC), which broadly includes the syndromes of coma, vegetative state [VS; also known as unresponsive wakefulness syndrome (UWS)] and minimally conscious state (MCS) (2,3). Over the past century, there have been few methods that reliably assess the consciousness of DOC patients, as methods of traditional behavioral assessment may be easily limited.…”

“…However, 10-15% patients who survive the acute coma stage enter into a chronic DOC (2,3). Therefore, the treatment and rehabilitation of patients with DOC is a major challenge in clinical neuroscience.…”