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Submitted: 2022-11-07
DOI: 10.35119/myjo.v6i2.327
Case Reports
Published: 2024-07-04

Acute cerebral venous sinus thrombosis presenting in papilloedema: a case report

Department of Ophthalmology, Neuro-Ophthalmology Division, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia
https://orcid.org/0000-0003-0463-5743
Department of Ophthalmology, Neuro-Ophthalmology Division, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia
https://orcid.org/0000-0002-1452-0141
Department of Ophthalmology, Neuro-Ophthalmology Division, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia
neuro-ophthalmology papilloedema superior sagittal sinus thrombosis

Abstract

Background: Papilloedema has several aetiologies, including brain tumours, central nervous system inflammation, cerebral venous thrombosis, cerebral venous sinus thrombosis (CVST), and idiopathic intracranial hypertension. CVST is a rare condition and a form of stroke with an incidence of 5:1,000,000/year.

Case presentation: A 23-year-old female developed impaired vision in her left eye, accompanied by headache, nausea, and vomiting, 5 weeks prior to hospitalization. Visual acuity in the left eye (OS) was 6/12, which improved to 6/9 on pinhole examination, and to 6/6 with S-0.50 and C-0.50 on the 180° axis. OS intraocular pressure (IOP) was 14 mmHg. Bilateral funduscopic examination revealed papilloedema, peripapillary venous tortuosity, and macular exudate. Both computerised tomography scan and magnetic resonance angiography examination detected superior sagittal sinus thrombosis.

Conclusion: Acute CVST is a rare condition. A good prognosis depends on early diagnosis and prompt treatment.