Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2023; 11(19): 4677-4683
Published online Jul 6, 2023. doi: 10.12998/wjcc.v11.i19.4677
Rare cause of cerebral venous sinus thrombosis: Spontaneous intracranial hypotension syndrome: A case report
Pan Huang
Pan Huang, Department of Neurology, People’s Hospital of Deyang City, Deyang 618000, Sichuan Province, China
Author contributions: Huang P performed all the work for this paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
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Corresponding author: Pan Huang, MD, Clinician, Department of Neurology, People’s Hospital of Deyang City, No. 173 Section 1, North Taishan Road, Deyang 618000, Sichuan Province, China. 1032857970@qq.com
Received: February 16, 2023
Peer-review started: February 16, 2023
First decision: March 24, 2023
Revised: March 28, 2023
Accepted: May 8, 2023
Article in press: May 8, 2023
Published online: July 6, 2023
Processing time: 134 Days and 3.9 Hours
Abstract
BACKGROUND

Spontaneous intracranial hypotension syndrome is a relatively uncommon neurological disorder of unknown etiology with a good prognosis. Cerebral venous sinus thrombosis is a specific type of cerebrovascular disease caused by multiple etiologies of cerebral venous sinus or vein thrombosis that obstructs cerebral venous return and is associated with impaired cerebrospinal fluid absorption; this entity is rarely seen clinically. Spontaneous intracranial hypotension syndrome is one of the causes of cerebral venous sinus thrombosis, and the probability of their combined occurrence is only 1%-2%. As such, it is easily overlooked clinically, thus increasing the difficulty of diagnosis and treatment.

CASE SUMMARY

A 29-year-old young woman presented with postural headache. Lumbar puncture suggested a pressure of 50 mmH2O (normal 80 mmH2O-180 mmH2O), and magnetic resonance imaging cerebral venography suggested thrombosis of the supratentorial sinus. These findings were considered indicative of cerebral venous sinus thrombosis due to spontaneous intracranial hypotension syndrome after ruling out immunological causes, tumor, infection, abnormal coagulation mechanism, and hypercoagulable state, etc. She was treated with rehydration and low-molecular heparin anticoagulation for 15 d, and follow-up magnetic resonance imaging cerebral venography suggested resolution of the thrombus. The patient had complete improvement of her headache symptoms.

CONCLUSION

Spontaneous intracranial hypotension syndrome is one of the rare causes of cerebral venous sinus thrombosis, which is frequently misdiagnosed or missed and deserves consideration by clinicians during differential diagnosis. Dehydration should be avoided in such patients, and early rehydration and anticoagulation therapy are effective treatment options.

Keywords: Spontaneous intracranial hypotension; Cerebral venous sinus; Thrombosis; Rehydration; Anticoagulation; Case report

Core Tip: In patients with cerebral venous sinus thrombosis of unknown origin, spontaneous intracranial hypotension syndrome may be considered as a rare cause. Lumbar puncture and cerebral venous sinus angiography are important diagnostic tools.