Carolinas Research Day 2021

Clinical Case-Based Studies

12 Dural Venous Sinus Thrombosis

Austin Belfiori, MSIV, Andrew Arteaga, MSIV, Lynn Campbell, DO

Edward Via College of Osteopathic Medicine-Carolinas, Prisma Health

Introduction: This is a case report detailing the importance of clinical awareness in the diagnosis of Dural Venous Sinus Thrombosis (DVST), a subset of Cerebral Venous Thrombosis (CVT) in the setting of a small community hospital emergency department. A 48-year-old female presented to the emergency department with a chief complaint of sudden onset headache, with 10/10 pain, localized to the left posteriorly. She stated that it woke her from sleep and worsened with cough and head movement. She also reported photophobia and nausea. The patient’s Neurologic, HEENT, and MSK exams were all benign. A non-contrast CT was ordered and came back negative. A follow up CTA revealed findings that

raised suspicion for CVT. CT venography was used to confirm the diagnosis of CVT and heparin therapy was initiated. The neurological consult and neurosurgery guided the remainder of the patient’s care. Patients with accurately diagnosed and correctly treated CVT typically have good outcomes. CVT has an annual incidence of less than 1.5 per 100,000, making it very uncommon1. Furthermore, its range of possible clinical presentations often make it difficult to identify. The rarity and host of clinical presentations associated with CVT make clinical awareness and imaging instrumental in a successful diagnosis.

60