Dural sinus thrombosis (DST) may cause elevated intracranial pressure that produces a syndrome similar to pseudotumor cerebri. When DST occurs without obvious cause, the search for a prothrombotic state is indicated. Defects in the proteins of the coagulation or fibrinolytic system have been associated with hypercoagulable states. We describe a patient with possible protein S deficiency and dysfibrinogenemia who presented with increased intracranial pressure from sagittal sinus thrombosis.
Report of a Case.
—A 24-year-old previously healthy man presented with headaches and tonic-clonic seizures. He denied transient visual obscurations, diplopia, or other neurologic symptoms. The patient's visual acuity was 20/20 OU and his color vision was normal. External examination results, pupils, motility, and anterior segments were normal, but funduscopy revealed swollen papillae. The Humphrey visual field revealed blind spot enlargement bilaterally. Neurological examination results were normal. Neuroimaging studies showed a frontal lobe abnormality that was confirmed on cerebral angiography to be
Pasquale LR, Moster ML, Schmaier A. Dural Sinus Thrombosis With Abnormalities of Protein S and Fibrinogen. Arch Ophthalmol. 1990;108(5):644. doi:10.1001/archopht.1990.01070070030013