warfarin and Papilledema

Topics: Anticoagulants; Female; Headache; Humans; Intracranial Hypertension; Magnetic Resonance Imaging; Middle Aged; Papilledema; Sinus Thrombosis, Intracranial; Warfarin

Topics: Anticoagulants; Cerebral Veins; Drug Therapy, Combination; Female; Heparin, Low-Molecular-Weight; Humans; Magnetic Resonance Angiography; Papilledema; Postpartum Period; Pregnancy; Puerperal Disorders; Sinus Thrombosis, Intracranial; Tomography, X-Ray Computed; Visual Acuity; Visual Fields; Warfarin; Young Adult

A 35-year-old healthy male with no history of any past medical illness developed severe headache, vomiting and drowsiness while at high altitude (4,572 m) in the eastern Himalayan ranges. He was evacuated to a tertiary-care hospital where he was diagnosed to have cerebral sinus venous thrombosis (CSVT) on magnetic resonance imaging, with deep vein thrombosis (DVT) of his right popliteo-femoral vein on color Doppler study. Investigation for thrombophilia revealed protein S (PS) deficiency in this patient. Family screening revealed low levels of PS in two elder brothers. One brother had a history of 'stroke in young' at the age of 20 years with the other being asymptomatic. This established the hereditary nature of PS deficiency. We are not aware of any previously published report on hereditary PS deficiency combined with CSVT and DVT occurring at high altitude. However, 1 case of protein C deficiency with CSVT has been reported previously.

Topics: Acclimatization; Adult; Altitude Sickness; Anticoagulants; Anticonvulsants; Cerebral Infarction; Family Health; Hemiplegia; Humans; Male; Military Personnel; Papilledema; Protein S Deficiency; Radiography; Recurrence; Sinus Thrombosis, Intracranial; Thrombophilia; Thrombophlebitis; Ultrasonography; Vomiting; Warfarin

Topics: Adult; Aged; Anti-Inflammatory Agents; Cyclophosphamide; Female; Fluorescein Angiography; Fundus Oculi; Glucocorticoids; Humans; Infusions, Intravenous; Macular Edema; Male; Methylprednisolone; Papilledema; Retinal Vein Occlusion; Visual Acuity; Warfarin

Antiphospholipid antibodies are known to be associated with increased risk of venous and arterial thrombotic events, including cerebral venous thromboses. Pseudotumor syndrome can be produced by cerebral venous thrombosis. A patient with cerebral venous thrombosis associated with antiphospholipid antibodies who exhibited pseudotumor syndrome is reported.. A 49-year-old man who noted visual blurring and persistent vertical wavy lines in his fields of vision was found to have papilledema. Cerebrospinal fluid values were normal except for an opening pressure increase to 510 mm of fluid. His visual symptoms improved with lumbar puncture and the use of acetazolamide. Imaging studies showed that the transverse sinus was occluded completely on the left and partially on the right and that there was a small left cerebellar cortical venous infarction.. Antiphospholipid syndrome should be considered in the differential diagnosis of pseudotumor syndrome related to cerebral venous thrombosis.

Topics: Acetazolamide; Antibodies, Antiphospholipid; Cerebral Angiography; Cerebral Veins; Hearing Loss, Noise-Induced; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Papilledema; Pseudotumor Cerebri; Thrombophlebitis; Warfarin