A 31-year-old female with a history of iron deficiency anemia and migraines presented with a week-long left-sided headache, dizziness, and intermittent weakness in her legs. Her symptoms persisted, leading to her admission to the emergency department (ED). On further evaluation, the patient exhibited signs of ear pain and decreased hearing, as well as erythematous, bulging tympanic membranes. A thorough workup and imaging revealed a subdural hematoma, cavernous sinus thrombosis (CST), and restricted diffusion in the left frontal lobe. Neurosurgery consultation confirmed CST as the primary cause of her symptoms. The patient was started on anticoagulation therapy and transferred emergently to a higher-level trauma center. This case underscores the importance of considering CST in patients with unexplained headache, dizziness, neurological symptoms, and possible underlying hypercoagulable states [1]-[3]. Early recognition through imaging and appropriate treatment can significantly impact patient outcomes.
References
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Kuybu, O. and Dossani, R.H. (2020) Cavernous Sinus Syndromes. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532976/
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Housley, S.B., McPheeters, M.J., Raygor, K.P., Bouslama, M., Scullen, T. and Davies, J.M. (2024) Cavernous Sinus Thrombosis. Neurosurgery Clinics of North America, 35, 305-310. https://doi.org/10.1016/j.nec.2024.02.002
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Bhatia, H., Kaur, R. and Bedi, R. (2020) MR Imaging of Cavernous Sinus Thrombosis. European Journal of Radiology Open, 7, Article 100226. https://doi.org/10.1016/j.ejro.2020.100226
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Brissot, E., Troadec, M., Loréal, O. and Brissot, P. (2021) Iron and Platelets: A Subtle, Under-Recognized Relationship. American Journal of Hematology, 96, 1008-1016. https://doi.org/10.1002/ajh.26189
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Venugopalan Pathiyil, D., Henry, R.A., Joseph, J., Oomen, A.T. and Janardhanan Kakkra, J. (2021) Severe Iron Deficiency Anemia Leading to Thrombocytosis with Arterial and Venous Thrombosis. Cureus, 13, e17893. https://doi.org/10.7759/cureus.17893
