Abstract
We report a 27-year-old male who presented with headache and rapid visual impairment. He had been diagnosed with venous sinus thrombosis 3 months earlier, when he had diffuse headache, nausea and vomiting, which subsided after incomplete thrombolytic therapy. Warfarin was then prescribed without screening for coagulopathy. Ophthalmic examination revealed bilateral papilloedema, splinter hemorrhage and lipid exudates. Neuroradiological studies including magnetic resonance imaging and cerebral angiography revealed chronic partial thrombosis over superior sagittal sinus, left side transverse sinus, right side transverse and venous confluence with engorged cortical veins and secondary dural arteriovenous malformation (AVM) and reversed flow over bilateral superior orbital veins, and thrombolytic therapy was considered not feasible. Clot-assay protein S activity was decreased (25%, normal range: 65-140%). No underlying connective tissue diseases or other coagulopathies were noted. The patient's vision failed to respond to aggressive medical treatment, and he received lumboperitoneal shunt in another hospital. His vision was improved. For young patients with occlusive cerebrovascular disorder, extensive hematological investigation for coagulopathy is strongly recommended.
| Original language | English |
|---|---|
| Pages (from-to) | 521-526 |
| Number of pages | 6 |
| Journal | Journal of the Chinese Medical Association |
| Volume | 67 |
| Issue number | 10 |
| Publication status | Published - Oct 1 2004 |
| Externally published | Yes |
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Keywords
- Increased intracranial pressure
- Intracranial venous sinus thrombosis
- Protein S deficiency
ASJC Scopus subject areas
- Medicine(all)
Cite this
Protein S deficiency associated with progressive loss of vision and intracranial venous sinus thrombosis. / Chen, Pei Y.; Hu, Han H.; Chang, Fon C.; Chern, Chang Ming.
In: Journal of the Chinese Medical Association, Vol. 67, No. 10, 01.10.2004, p. 521-526.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Protein S deficiency associated with progressive loss of vision and intracranial venous sinus thrombosis
AU - Chen, Pei Y.
AU - Hu, Han H.
AU - Chang, Fon C.
AU - Chern, Chang Ming
PY - 2004/10/1
Y1 - 2004/10/1
N2 - We report a 27-year-old male who presented with headache and rapid visual impairment. He had been diagnosed with venous sinus thrombosis 3 months earlier, when he had diffuse headache, nausea and vomiting, which subsided after incomplete thrombolytic therapy. Warfarin was then prescribed without screening for coagulopathy. Ophthalmic examination revealed bilateral papilloedema, splinter hemorrhage and lipid exudates. Neuroradiological studies including magnetic resonance imaging and cerebral angiography revealed chronic partial thrombosis over superior sagittal sinus, left side transverse sinus, right side transverse and venous confluence with engorged cortical veins and secondary dural arteriovenous malformation (AVM) and reversed flow over bilateral superior orbital veins, and thrombolytic therapy was considered not feasible. Clot-assay protein S activity was decreased (25%, normal range: 65-140%). No underlying connective tissue diseases or other coagulopathies were noted. The patient's vision failed to respond to aggressive medical treatment, and he received lumboperitoneal shunt in another hospital. His vision was improved. For young patients with occlusive cerebrovascular disorder, extensive hematological investigation for coagulopathy is strongly recommended.
AB - We report a 27-year-old male who presented with headache and rapid visual impairment. He had been diagnosed with venous sinus thrombosis 3 months earlier, when he had diffuse headache, nausea and vomiting, which subsided after incomplete thrombolytic therapy. Warfarin was then prescribed without screening for coagulopathy. Ophthalmic examination revealed bilateral papilloedema, splinter hemorrhage and lipid exudates. Neuroradiological studies including magnetic resonance imaging and cerebral angiography revealed chronic partial thrombosis over superior sagittal sinus, left side transverse sinus, right side transverse and venous confluence with engorged cortical veins and secondary dural arteriovenous malformation (AVM) and reversed flow over bilateral superior orbital veins, and thrombolytic therapy was considered not feasible. Clot-assay protein S activity was decreased (25%, normal range: 65-140%). No underlying connective tissue diseases or other coagulopathies were noted. The patient's vision failed to respond to aggressive medical treatment, and he received lumboperitoneal shunt in another hospital. His vision was improved. For young patients with occlusive cerebrovascular disorder, extensive hematological investigation for coagulopathy is strongly recommended.
KW - Increased intracranial pressure
KW - Intracranial venous sinus thrombosis
KW - Protein S deficiency
UR - http://www.scopus.com/inward/record.url?scp=11244322124&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=11244322124&partnerID=8YFLogxK
M3 - Article
C2 - 15648287
AN - SCOPUS:11244322124
VL - 67
SP - 521
EP - 526
JO - Journal of the Chinese Medical Association
JF - Journal of the Chinese Medical Association
SN - 1726-4901
IS - 10
ER -