Bilateral Abducens Nerve Palsy Due to Extensive Cerebral Venous Sinus Thrombosis

Medicina (Kaunas). 2019 Apr 23;55(4):115. doi: 10.3390/medicina55040115.

Abstract

Cerebral venous sinus thrombosis (CVST) is a relatively rare condition. We present a case of an acute aseptic thrombosis of the sagittal, transverse and sigmoid sinus in a puerperium patient with protein S deficiency. The specifics of the case include high intracranial pressure (ICP) caused by sinus thrombosis with typical symptomatology and bilateral papilloedema, which also manifested in transient bilateral abducens nerve palsy and, consequently, bilateral horizontal diplopia. The recovery of the cranial nerve function occurred 3 to 4 weeks after it was initially reported. Prompt and adequate anticoagulant therapy contributed to the almost complete recanalization of the dural venous sinus thrombosis and a positive outcome of the disease.

Keywords: abducens palsy; cerebral venous sinus thrombosis; papilloedema; protein S deficiency.

Publication types

  • Case Reports

MeSH terms

  • Abducens Nerve Diseases / etiology*
  • Adult
  • Anticoagulants / therapeutic use*
  • Diplopia
  • Diuretics / therapeutic use
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Intracranial Pressure
  • Magnetic Resonance Angiography
  • Papilledema / drug therapy
  • Papilledema / etiology
  • Protein S Deficiency
  • Sagittal Sinus Thrombosis / complications*
  • Sagittal Sinus Thrombosis / diagnostic imaging
  • Sagittal Sinus Thrombosis / drug therapy*
  • Tomography Scanners, X-Ray Computed
  • Treatment Outcome
  • Venous Thrombosis / complications*
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / drug therapy*
  • Young Adult

Substances

  • Anticoagulants
  • Diuretics