Neurológia pre prax 5/2010

Cerebral venous trombosis covered by migraine

A 26-year-old patient, currently on hormonal contraceptive medication, with a prior medical history of common migraine and a mild head injury was admitted in our department for typical presentation of a migrenous headache. No significant neurological findings during her medical examination. Due to the prolonged course of a headache, risk factors and changes in presentation of a headache a CT scan was requested. Due to the suspission of venous thrombosis MRI of the brain was also requested. Thrombosis of the sigmoid and transverse sinuses were proven. It is a tendency or common practise, not to pay so much attention as to include secondary cause of a headache, in the differential diagnosis of patients already suffering from the primary headaches. Therefore it is necessary to consider morphological examination of a brain, especially when there is an atypical presentation headache combined with other major risk factors. The objective of the case study is to highlight the problems associated with the diagnosis of cerebral venous thrombosis, in a patient suffering primary headaches.

Keywords: cerebral venous trombosis, migraine, diagnosis.