Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

CASE REPORT
Zylfije Hundozi, MD, PhD¹*; Nazmie Ibishi, MD, PhD²; Fisnik Jashari, MD, PhD¹; Jehona Rrustemi, MD¹; Bujar Gjikolli, MD³

¹Department of Neurology, University Clinical Center of Kosovo; ²Department of Psychiatry, University Clinical Center of Kosovo; ³Department of Radiology, University Clinical Center of Kosovo; Prishtina, Kosovo

*Corresponding author: Prof. Zylfije Hundozi MD, PhD. Department of Neurology, University Clinical Center of Kosovo, Prishtina, Kosovo. E-mail: zylhundozi@hotmail.com

Published: December 16, 2016.  DOI: 10.21103/Article6(4)_CR2

Abstract: 

Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS) thrombosis (SSST) developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA) demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH) followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk.

Keywords: 
cerebral venous sinus thrombosis, hallucinations, tonic-clonic seizure, puerperium
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