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Published on: June 2, 2014
Severe headache as a presenting complaint in sigmoid sinus thrombosis complicated by functional overlay
Pradhyuman Chaudhary1, Girish Banwari1, Nimesh Parikh1
1Department of Psychiatry, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College and Sheth Vadilal Sarabhai General Hospital, Ahmedabad, Gujarat, India.
A severe organic condition, sigmoid sinus thrombosis, was complicated by functional symptoms. Psychological intervention effectively managed the persistent headaches, highlighting the need for integrated psychiatric care.
Area of Science:
- Neurology
- Neuroimaging
- Psychiatry
Background:
- Serious organic conditions can present with superimposed functional symptoms.
- Accurate diagnosis requires considering both organic and functional components.
Observation:
- A patient with severe occipital headaches and blurred vision initially showed normal brain CT.
- Subsequent MRI and MR venography revealed right sigmoid sinus thrombosis.
Findings:
- Anticoagulation for thrombosis did not resolve headaches, suggesting a functional overlay.
- Psychosocial stressors were identified, and psychological intervention successfully treated the headaches.
Implications:
- Functional overlay can complicate severe organic neurological conditions.
- Integrated psychiatric care is crucial for comprehensive management.
- This case underscores the importance of a holistic patient assessment.
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