Arthur Jason, Duran-Gehring Petra, Kumetz Christopher, Chadwick Steven, McIntosh Mark
Department of Emergency Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida.
J Emerg Med. 2019 Mar;56(3):288-293. doi: 10.1016/j.jemermed.2018.10.036. Epub 2018 Dec 8.
Cerebral venous thrombosis (CVT) is a rare, difficult-to-diagnose form of venous thromboembolic disease and is considered a type of stroke. Its presentation is highly variable and may be easily confused for more common and less debilitating or life-threatening diagnoses such as migraine, seizure, or idiopathic intracranial hypertension.
A 25-year-old woman presented with a complaint of bifrontal throbbing headache and blurry vision. A bedside ultrasound of the orbit suggested increased intracranial pressure. A subsequent computed tomography venogram demonstrated a left transverse sinus thrombosis. The patient was started on enoxaparin and admitted for bridging to warfarin and evaluation for hypercoagulable state. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: CVT is a rare form of stroke that carries a high rate of mortality and morbidity and masquerades as more common and benign diagnoses. Emergency department bedside ultrasound of the orbit may make the diagnosis of CVT more attainable by identifying patients with increased intracranial pressure.
脑静脉血栓形成（CVT）是一种罕见的、难以诊断的静脉血栓栓塞性疾病，被视为一种中风类型。其表现高度多变，可能容易与偏头痛、癫痫或特发性颅内高压等更常见、危害较小或无生命危险的疾病相混淆。
一名25岁女性因双额部搏动性头痛和视力模糊前来就诊。床边眼眶超声提示颅内压升高。随后的计算机断层扫描静脉造影显示左侧横窦血栓形成。患者开始使用依诺肝素治疗，并入院以便过渡到华法林治疗以及评估高凝状态。
急诊医生为何应了解此疾病？：CVT是一种罕见的中风形式，具有高死亡率和发病率，且表现类似更常见的良性疾病。急诊科床边眼眶超声通过识别颅内压升高的患者，可能使CVT的诊断更容易实现。
