Mierzwa Adam T, Aladamat Nameer, Ali Imran, Kung Lisa
Neurology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Neurohospitalist. 2024 Jul;14(3):288-290. doi: 10.1177/19418744241233796. Epub 2024 Feb 12.
Cerebral venous sinus thrombosis (CVST) is a rare and potentially fatal condition. It is believed to be one of the rare complications of lumbar puncture (LP), however other causes and risk factors should be considered and ruled out. Diagnosis can be challenging after an LP as it can mimic low pressure or post dural puncture. We present a 23-year-old patient diagnosed with CVST following a diagnostic lumbar puncture, in the absence of other risk factors. The patient presented with a persistent headache that was initially attributed to low CSF pressure, as well as a transient episode of right hemi-body paresthesia. Neuroimaging including contrasted MRI with venography confirmed the diagnosis. The patient had negative hypercoagulable evaluation and was placed on anticoagulation on discharge. Our report highlights the importance of considering CVST in refractory headaches after LP and the value of neuroimaging when indicated.
脑静脉窦血栓形成(CVST)是一种罕见且可能致命的疾病。它被认为是腰椎穿刺(LP)的罕见并发症之一,然而,应考虑并排除其他病因和危险因素。腰椎穿刺后诊断可能具有挑战性,因为它可能类似于低颅压或硬膜穿刺后综合征。我们报告一例23岁患者,在无其他危险因素的情况下,诊断性腰椎穿刺后被诊断为CVST。患者出现持续性头痛,最初归因于脑脊液压力过低,以及一过性右侧半身感觉异常。包括增强磁共振静脉造影成像在内的神经影像学检查确诊了该诊断。患者高凝状态评估结果为阴性,出院时接受了抗凝治疗。我们的报告强调了在腰椎穿刺后难治性头痛中考虑CVST的重要性以及在有指征时进行神经影像学检查的价值。