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Cerebral venous sinus thrombosis

Description

A 28 year old male presented with headache and vision loss of 2 months duration. MRV revealed complete thrombosis of left transverse and sigmoid sinus with grade 2 collaterals development as appreciated in imaging. T2W orbital cuts also revealed bilaterally distended optic nerve sheaths, confirming secondary intracranial hypertension due to sinus thrombosis. Corresponding bilateral fundus examination showed bilateral disc edema in the form of blurred disc margins, multiple cotton wool spots and partially formed macular star in the right eye. Anticoagulation with anti ICP measures was initiated along with optic nerve sheath fenestration which prevented further progression of vision loss. Therapeutic CSF drainage was attempted with optimum hydration in view of very high opening CSF pressure.

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