Cerebral venous thrombosis initially presenting with left occipital hemorrhage and headache.

Cerebral venous thrombosis (CVT) can be difficult to diagnose because of its wide spectrum of clinical manifestations. In the present article, we report a 58-year-old man coming to our emergency department presenting with left temporal throbbing headache and right hemianopia. Computed tomography of the brain revealed acute hemorrhages over the left occipital area. Due to the unusual location of hemorrhage, magnetic resonance venography was performed, revealing absence of venous flow over the superior sagittal and transverse sinuses suggestive of CVT. He received anticoagulant therapy for 6 months and the headache subsided. We feel that a high index of clinical suspicion is needed to diagnose an intracerebral hemorrhage in an uncommon site caused by CVT, even if risk factors of CVT are not present, so that appropriate treatment can be initiated as promptly as possible. Failure to recognize the signs of CVT could result in inappropriate management and suboptimal secondary prophylaxis strategies, which could affect the patient's clinical outcome.