[Thrombosis of the cerebral venous sinuses in the differential diagnosis of idiopathic intracranial hypertension in young obese females: is it a real problem?].

Abstract

INTRODUCTION:

Idiopathic intracranial hypertension (IICH) typically presents in young women with obesity or a recent weight increase. The differential diagnosis of IICH includes thrombosis of the cerebral venous sinuses (TCVS), which can also present as an isolated intracranial hypertension syndrome. We review the frequency with which patients with a typical IICH profile presented TCVS as their diagnosis.

PATIENTS AND METHODS:

The study consisted in a retrospective review of all the admissions due to intracranial hypertension syndromes in our centre between 2000 and 2011. The cases selected were those with a normal cerebrospinal fluid study and computerised axial tomography scan of the head that presented as an isolated intracranial hypertension syndrome; those who manifested a focal neurological picture, however, were excluded. From the patients that were included, a subgroup made up of females between 16 and 35 years of age with a body mass index of above 25 were selected.

RESULTS:

A total of 37 cases were obtained. Of these, 35 (94.6%) were cases of IICH and two (5.4%) were TCVS. The time elapsed between the onset of symptoms and diagnosis was less than seven days in both cases of TCVS (100%) and in two cases (5.4%) of IICH.

CONCLUSIONS:

Up to 5.4% of patients with a typical IICH profile that present with an intracranial hypertension syndrome can present TCVS. The presence of prothrombotic factors and a high D-dimer can suggest this possibility, although there is still a need for well-established parameters that allow decisions to be made in emergencies in the absence of any chance of performing an urgent MR phlebography scan.

• Authors: Fernando Cabrera-Naranjo, Ayoze Gonzalez-Hernandez, Iria Lagoa-Labrador, Óscar Fabre-Pi
• Journal: Revista de neurologia (Rev Neurol) Vol. 56 Issue 8 Pg. 420-4 (Apr 16 2013) ISSN: 1576-6578 [Electronic] Spain
• Vernacular Title: Trombosis de senos venosos cerebrales en el diagnostico diferencial de la hipertension intracraneal idiopatica en mujeres jovenes obesas: un problema real?
• PMID: 23568684 (Publication Type: English Abstract, Journal Article)

Chemical References

• Fibrin Fibrinogen Degradation Products
• fibrin fragment D

Topics

• Adolescent
• Adult
• Body Mass Index
• Diagnosis, Differential
• Emergencies
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Headache (etiology)
• Humans
• Intracranial Hypertension (etiology)
• Obesity (complications)
• Pseudotumor Cerebri (etiology)
• Retrospective Studies
• Sinus Thrombosis, Intracranial (blood, complications, diagnosis, epidemiology)
• Thrombophilia (blood, etiology)
• Young Adult