A Bloody Mess!

Surv Ophthalmol. 2018 Mar-Apr;63(2):268-274. doi: 10.1016/j.survophthal.2017.05.004. Epub 2017 May 18.

Abstract

A 15-year-old girl presented with a unilateral sixth nerve palsy and papilledema after a severe headache. Magnetic resonance imaging showed thrombosis of the superior sagittal sinus and proximal right transverse sinus that were attributed to oral contraceptive use after a coagulation workup was negative. Systemic anticoagulation caused a hemorrhagic papillopathy in both eyes, raising the question as to whether anticoagulation should be discontinued. Diagnostic and management issues regarding cerebral venous sinus thrombosis with secondary intracranial hypertension are discussed.

Keywords: cerebral venous sinus thrombosis; intracranial hypertension; optic disk hemorrhage; papilledema.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Diagnosis, Differential
  • Female
  • Humans
  • Intracranial Hypertension / complications*
  • Intracranial Hypertension / diagnosis
  • Magnetic Resonance Imaging / methods*
  • Optic Disk / diagnostic imaging*
  • Papilledema / diagnosis
  • Papilledema / etiology*
  • Photography
  • Sinus Thrombosis, Intracranial / complications*
  • Sinus Thrombosis, Intracranial / diagnosis