A Case of Cerebral Venous Sinus Thrombosis Presenting with Delirium
Journal Title: Advanced Journal of Emergency Medicine - Year 2019, Vol 3, Issue 1
Abstract
A 73-year-old woman with no history of headache, seizure and trauma was admitted to the emergency department complaining about fever, vomiting and delirium for 3 days. She was lethargic upon admission and her blood pressure (BP) was recorded as 140/90 mm/Hg, her pulse rate (PR) as 75 beat/min and oral temperature as 38 °C. No localizing findings were observed in neurological examinations. Laboratory findings were as follows: White Blood Cell (WBC) count: 7,000/mm3, Hemoglobin: 13 g/dl, Platelet count: 300000. Lumbar CSF, blood and urine cultures were found to be negative for infections. Brain Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) were also performed. MRI showed filling defects in the left transverse sinus, the jugular bulb and the internal jugular vein. Moreover, hyper-intense signal was observed in the left temporal lobe (T1 sequence) suggesting hemorrhagic venous infarction (Figure1). The obtained results were confirmed by Magnetic Resonance Venography (MRV) of the brain (Figure2). The patient underwent anticoagulation therapy using LMWH and she was? hydrated using physiologic solution. The patient’s symptoms disappeared and she was then followed up regularly.
Authors and Affiliations
Mahnaz Pejman-Sani, Mahbube Ebrahimpur
Reverse Triage to Increase the Hospital Surge Capacity in Disaster Response
Introduction: Successful and effective management of large-scale disasters and epidemics requires pre-established systematic plans to minimize the damage and control the situation. With an increasing number of people in...
Educational Intervention Effect on Pain Management Quality in Emergency Department; a Clinical Audit
Introduction: Pain is a frequent complaint of patients who are referred to the emergency department (ED), which is ignored or mismanaged and, almost always, approached in terms of determining the cause of pain instead of...
A 58-Year-Old Woman with Weakness and Shortness of Breath
The patient was a 58-year-old woman with a history of mitral valvuloplasty, presenting to the emergency department (ED) due to weakness and shortness of breath. Her vital signs were stable. The patient’s electrocardiogra...
Pituitary Macroprolactinoma with Mildly Elevated Serum Prolactin: Hook Effect
A 45-year-old man was admitted in our department with complaints of severe headache for over 6 months period. He also suffered from several problems such as visual field defect, decreased energy and libido, body hair los...
Emergency Medicine as an Academic Discipline: Giants strides along an Endless Path
For many years, emergency care had been abandoned and left in the hands of practitioners whose main interest was not working in the not-so-much respected “emergency room (ER)”. They were usually obliged to serve the firs...