Dural Venous Sinus Thrombosis Presenting with an Unusual Diffuse Subarachnoid Hemorrhage

, Do-Youl Lee; , Dong-Hyuk Park; , Jung-Yul Park; , Yong-Gu Chung

Case Report

Journal of Korean Society of Geriatric Neurosurgery 2012;8(2):180-183.
Published online December 30, 2012.

Dural Venous Sinus Thrombosis Presenting with an Unusual Diffuse Subarachnoid Hemorrhage

Do-Youl Lee , Dong-Hyuk Park , Jung-Yul Park , Yong-Gu Chung

Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea

Abstract

Cerebral venous sinus thrombosis very rarely causes subarachnoid hemorrhage (SAH), which is almost focal and small. We report a case of dural venous sinus thrombosis with diffuse, thick SAH in the bilateral cerebral hemispheres and posterior fossa. Digital subtraction angiography (DSA) and computed tomography angiography did not show any aneurysms as a cause of the SAH except the occlusion of the transverse sinus with a thinned-out sigmoid sinus and jugular vein on the left side. Anticoagulation was scheduled after performing the next follow-up angiogram because of the thick hemorrhage and the fear of hidden aneurysms. On admission day 13, a follow-up DSA showed the same findings as the previous angiograms, and then the anticoagulation was started. Two days after anticoagulation, the brain swelling without additional hemorrhage was suddenly aggravated and the patient’s mental status changed into coma. Finally, the patient died 18 days after admission.

Key Words: Cerebral venous sinus thrombosisㆍAngiography negative subarachnoid hemorrhageㆍVenous infarction