ABDUCENS NERVE PALSY AND THROMBOSIS OF THE CEREBRAL VEINS AND SINUSES - A DIAGNOSTIC PITFALL
Journal Title: Journal of IMAB - Annual Proceeding (Scientific Papers) - Year 2012, Vol 18, Issue 3
Abstract
Thrombosis of the cerebral veins and sinuses is an infrequent cerebrovascular disorder. Because the highly variable symptoms, recent neuroimaging plays a key role in the diagnosis. Abducens nerve palsy as a focal neurological deficit is a rare clinical manifestation in these patients. We present two cases with sudden onset of diplopia and headache. Case 1: A 3-year old girl with B cell lymphoblastic leukemia developed bilateral abducens deficit and bilateral optic disc edema after treatment including L-asparaginase. Thrombosis of the right jugular vein, sagittal and right sigmoid sinuses was visualized on magnetic resonance imaging (MRI) and magnetic resonance venography (MRV). Symptoms gradually resolved after treatment with enoxiparine and MRV demonstrated recanalization. Case 2: A 75-year old female with medical history of arterial hypertension presented with headache and sudden left abduction deficit. Computerized tomography (CT) scan was normal. MRI and MRV revealed aging brain and disruption of venous flow at the left internal jugular vein, suspecting thrombosis. Extracranial colour duplex sonography and CT angiography proved haemodinamic equivalent of left internal jugular vein thrombosis due to sclerotic pathology of aortic arch. Our first case illustrates the role of improved neuroimaging techniques as the best method for diagnosis of cerebral veins and sinuses thrombosis, presenting with abducens nerve palsy. With second case the potential neuroimaging pitfalls concerning the accurate diagnosis of these cerebrovascular disorders with neuro-ophthalmologic manifestation are discussed .
Authors and Affiliations
Alexandra Tzoukeva, Ara Kaprelyan, Valeria Kaleva, Chavdar Bachvarov, Radoslav Georgiev, Elina Peteva
Keywords
Related Articles
- EP ID EP93704
- DOI 10.5272/jimab.2012183.349
- Views 113
- Downloads 0
CIVIL PROTECTION MODERN ASPECTS IN CASE OF DISASTERS – BULGARIA
This article aims on the modern aspects of Civil Protection in Bulgaria by thorough research of the management and the organization of its activities. We used descriptive analysis and summary of scientific publications a...
THROMBOCYTOSIS AS PROGNOSTIC FACTOR FOR SURVIVAL IN PATIENTS WITH ADVANCED NON SMALL CELL LUNG CANCER TREATED WITH FIRST- LINE CHEMOTHERAPY.
Objective: The aim of this study was to evaluate elevated platelet count as a prognostic factor for survival in patients with advanced (stage IIIB/ IV) non- small cell lung cancer (NSCLC) receiving first- line chem...
NEW STRATEGIES IN LIVER SURGERY FOR IV STAGE METASTATIC COLORECTAL CANCER.
With recent advances in chemotherapy, traditional clinicopathological factors should not be used to exclude otherwise resectable patients from surgery. Pathological or clinical response to chemotherapy has become valuabl...
ODONTOGENIC MYXOMA- A RARE CASE AND DIAGNOSTIC AND THERAPEUTIC CHALLENGES.
Introduction: The odontogenic myxoma is generally considered to be a rare neoplasm unique to the jaws. In the international histological classification of odontogenic tumors, odontogenic myxoma (OM) is defined as a benig...
SUBGINGIVAL MICROBIOTA IN SEVERE CHRONIC PERIODONTITIS.
Literature data relate certain Gram-negative anaerobe microorganisms with advanced destructive periodontal lesion. There are some references which reported higher levels of periodontal pathogens by the red and oran...