Welcome to the WSC 2022 Interactive Program

Background and Aims

Cerebral Sinus venous thrombosis (CSVT) can have common manifestasion such as headache (80-90%), neurological deficit (40%) and seizure, or a rare manifestation such as Transient Ischemic Attack (TIA). There are only a few case reports regarding CSVT that manifest as TIA

Methods

A female patient, 23 years old, vegetarian, hospitalized with headaches accompanied by sudden weakness of the right side of the body, blurred vision, right 6^th cranial nerve palsy and hemihypesthesia two hours before admission that recovered completely within a few hours, but repeatedly returned with the same symptoms and experienced another recovery. There is a history of chronic headaches, seizures and right hemihypesthesia since 2018 with normal MRI and EEG finding, that has been treated by several neurologist with no clinical improvement. There are normal results on NCCT, CTA, MRA, echocardiography, and autoimmune markers. The laboratory test show slightly increase in D-dimer level. The DSA find occlusion in confluence of sinus as the possible etiology, so the CSVT with TIA manifestation is established.

Results

We treat patient with intravenous Heparin for 5 days and followed by Warfarin until patient discharge. There are complete resolution of symptoms with mild headache as the remaining symptom left.

Conclusions

This case shows a TIA with benign intracranial hypertension as a very rare manifestation of CSVT that requires clinical knowledge in diagnosis. We propose clinicians to assess the possibility of CSVT in young patients with complaints of headaches accompanied by TIA.

Background and Aims

Transient global amnesia (TGA) has traditionally been considered as one of the possible variants of cerebral ischemic attacks. There is no unambiguous explanation for the pathogenesis of this syndrome. Conducting a full-fledged visualization examination is a mandatory element of diagnosis in this category of patients.

Methods

Here is an example of a patient M. 67 years old, who applied accompanied by relatives, with complaints of disorientation in place, time, loss of memory for events within 1.5 hours before admission.

Results

In the anamnesis indication of arterial hypertension, dyslipidemia. In neurological status without focal symptoms. CT brain did not reveal any acute ischemia. MRI in DWI mode revealed a zone of altered signal measuring 0.4 x 0.5 cm at the level of the midbrain in the projection of the reticular formation.

Ultrasound examination did not reveal a hemodynamically significant lesion of the brachiocephalic arteries. ECG monitoring did not reveal cardiac arrhythmias. Rapid regression of symptoms clinically corresponded to the diagnosis of TGA. However, taking into account the MRI data, the diagnosis of lacunar infarction was made.

Conclusions

Transient global amnesia may be a rare variant of lacunar cerebral stem infarction located at the level of the reticular formation. MRI studies should be performed on patients with a clinical diagnosis of TGA.