Cerebral venous sinus thrombosis as initial manifestation of polycythemia vera in a young man- a case report

Sņežana Romaņuka, Nadīne Muciņa, Vija Siliņa

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Abstract

Cerebral venous sinus thrombosis (CVST) is a life-threatening condition that is under-diagnosed, because of the wide spectrum of clinical presentation and etiology. Polycythemia vera (PV) causes hyperviscosity, therefore it’s commonly associated with thrombosis, but mostly arterial and rarely venous thrombosis. So,
PV is the rare risk factor of CVST.

We report a case of a 31-year-old man presented to the emergency room with a headache that radiated to the right eye for three weeks. Complete blood count showed elevated hemoglobin (18.00 g/dl), hematocrit (55.3%) and red cell count (6.26*109 /l), but the head CT detected no abnormality. Patient was discharged
from the emergency room with no specific diagnosis for further outpatient care. Head MRI was performed only after month, because of a progressively worsening headache, and revealed CVST. PV diagnosis was established after further tests and Orfarin therapy was started immediately. The patient went to Germany
for further threatment, where he had two phlebotomies. After the first one he showed significant clinical improvement, but his HCT levels were still higher than 45% and now the ropeginterferon alfa-2B therapy is considered.

This case is presented, because of the low reported association of PV leading to CVST. Also, as it can be seen in this case, CVST diagnosis should be considered, even with normal head CT, and PV need to be considered if complete blood count reveals elevated hemoglobin, hematocrit levels or if CVST occurs. MRI should be performed in sudden onset headaches.
Original languageEnglish
Pages1154
Number of pages1
Publication statusPublished - 2020
Event25th European Conference of Family Doctors - Virtual, Berlin, Germany
Duration: 16 Dec 202019 Dec 2020
Conference number: 25
https://www.woncaeurope.org/page/past-conferences
https://archive.woncaeurope.org/www.familydoctorseurope2020.org/

Conference

Conference25th European Conference of Family Doctors
Country/TerritoryGermany
CityBerlin
Period16/12/2019/12/20
Internet address

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)

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