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Elevated Factor VIII Level Associated with Transverse Cerebral Venous Sinus Thrombosis.
Muhammad Shabbir Rawala1, Muhammad Muslim Noorani2, Rajat Gulati3
1Department of Medicine, Charleston Area Medical Center, Charleston, WV, USA.
The American Journal of Case Reports
|March 3, 2019
Summary
Cerebral venous sinus thrombosis (CVST) is a rare stroke cause. This case highlights an unusual CVST presentation in a patient with elevated factor VIII levels, emphasizing prompt diagnosis and treatment.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Cerebral venous sinus thrombosis (CVST) is an uncommon stroke etiology.
- CVST arises from systemic conditions or mechanical factors impeding venous blood flow.
- Risk factors include hormonal therapies, pregnancy, malignancy, genetic predispositions, trauma, surgery, and infections.
Observation:
- A 50-year-old female presented with headache and diplopia.
- Initial cerebral MRI revealed right transverse sinus thrombosis.
- No prior CVST risk factors were identified in the patient.
Findings:
- Extensive procoagulant workup identified elevated factor VIII levels as the sole abnormality.
- Treatment involved heparin infusion transitioning to coumadin for anticoagulation.
- The patient experienced symptom resolution and was discharged for outpatient follow-up.
Implications:
- This case underscores the importance of considering CVST in patients presenting with neurological symptoms, even without typical risk factors.
- Elevated factor VIII levels may represent an underlying prothrombotic state contributing to CVST.
- Prompt diagnosis and initiation of antithrombotic therapy are crucial for favorable outcomes in CVST.
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