Unprovoked Cerebral Venous Infarction Presenting as Audio-Visual Hallucinations: A Case Presentation.

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disease, accounting for 0.5% of all strokes.
• CVST often presents variably, and delayed diagnosis can lead to severe outcomes.
• Typical risk factors include hypercoagulable states or family history, often diagnosed in young adults.

Purpose of the Study:

• To report an unusual case of CVST presenting with audio-visual hallucinations in a young patient.
• To highlight the importance of considering CVST in patients with atypical neurological symptoms.
• To emphasize the need for prompt diagnosis and treatment in suspected CVST cases.

Main Methods:

• Case report of a 26-year-old male with no prior medical history.
• Clinical presentation included audio-visual hallucinations, transient movements, and headache.
• Diagnostic workup involved CT angiography, CT venography, and digital subtraction angiography.

Main Results:

• Imaging revealed nonocclusive thrombi in right posterior temporal cortical veins and the right sigmoid sinus.
• The patient experienced hallucinations and convulsions, treated initially with antiseizure medication.
• Successful treatment involved intravenous heparin followed by oral anticoagulation.

Conclusions:

• This case represents the first documented instance of a young patient without risk factors developing hallucinations secondary to CVST.
• A high index of suspicion is necessary for early CVST diagnosis, even with atypical presentations.
• Prompt recognition and management of CVST are vital to prevent devastating neurological consequences.