First-Time Generalized Seizure and Headache – Case Report
Neurovaskuläres Zentrum shared a post on LinkedIn:
“-A 52-year-old male patient presented due to a first-time generalized seizure and headache
-CCT revealed strong suspicion of thrombosis of a prominent cortical vein in the left frontotemporal region, particularly involving the Vein of Trolard and the Vein of Sylvius and their branches, indicated by pre-existing hyperdensity
-CTA showed an isolated occlusion of the left superficial superior anastomotic vein (Vein of Trolard), extending into the superficial middle cerebral vein (Vein of Sylvius) and into the sphenoparietal sinus
-The patient was admitted to the stroke unit and therapeutic anticoagulation was initiated using an aPTT-guided heparin infusion
-Over the course of hospitalization, there was clinical deterioration and worsening of headaches
-Imaging showed slight progression of the thrombosis
-Follow-up cMRI showed a localized diffusion restriction surrounding the thrombosis, indicating the onset of thrombus resorption. FLAIR sequences showed faint parieto-temporal and occipito-temporal hyperintensities, consistent with mild edema
-Overlapping anticoagulation therapy with warfarin (Marcoumar) was initiated
-At last follow-up, the patient still had mild aphasia with somewhat hesitant speech and fine motor impairment of the right hand.
Prof. Dr. Wilhelm Nacimiento Dr. med. Martin Schlunz-Hendann Prof. Dr. Martin Scholz”
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