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Deep cerebral venous thrombosis presenting as acute amnestic syndrome

A K Daif1, A Awada, S A Rajeh

  • 1Division of Neurology, King Khalid University Hospital, Riyadh, Saudi ArabiaDepartment of Radiology, King Khalid University Hospital, Riyadh, Saudi Arabia.

European Journal of Neurology
|November 29, 2013
PubMed

Insights

A patient with memory loss was diagnosed with deep cerebral venous thrombosis due to protein S deficiency. Early anticoagulation after a pulmonary embolism led to an excellent outcome, highlighting the importance of considering this condition.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Radiology

Background:

  • Deep cerebral venous thrombosis (CVT) is a rare condition that can present with diverse neurological symptoms.
  • Memory impairment can be a presenting symptom of CVT, often mimicking other neurological disorders.
  • Thrombosis of deep cerebral veins, including the vein of Galen and straight sinus, poses a significant risk of stroke and neurological deficit.

Purpose of the Study:

  • To investigate the case of a patient with amnestic syndrome caused by deep cerebral venous thrombosis.
  • To highlight the diagnostic challenges and therapeutic implications of CVT presenting as memory impairment.
  • To emphasize the potential for favorable outcomes with early anticoagulation in CVT.

Main Methods:

  • A 45-year-old male patient presented with acute memory impairment.
  • Diagnostic workup included brain computed tomography (CT), magnetic resonance imaging (MRI), and cerebral angiography.
  • Cerebral angiography confirmed extensive thrombosis of the vein of Galen and the straight sinus.

Main Results:

  • Brain imaging revealed multiple low-density areas in the deep cerebral white matter, bilateral thalamic infarcts, and extensive venous thrombosis.
  • Protein S deficiency was identified as the likely underlying cause.
  • Heparin therapy was initiated following a pulmonary embolism, leading to an excellent clinical outcome.

Conclusions:

  • Deep cerebral venous thrombosis should be considered in the differential diagnosis of amnestic syndrome.
  • Early recognition and prompt anticoagulation therapy can significantly improve outcomes in CVT.
  • This case underscores the importance of a high index of suspicion for CVT in patients with unexplained neurological deficits.

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