Cerebral venous thrombosis presenting with subdural haematoma as first presentation for systemic lupus erythematosus with negative antiphospholipid antibodies
We report the case of a 30-year-old woman, without any previous comorbidities presenting with acute onset headache, altered sensorium and unsteadiness of gait. Neurological evaluation revealed a drowsy patient with papilloedema, bilateral lateral rectus palsy, generalised hyper-reflexia and up going...
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| creator | Alboudi, Ayman Sarathchandran, Pournamy Alrukn, Suhail Al Madani, Abubaker |
| description | We report the case of a 30-year-old woman, without any previous comorbidities presenting with acute onset headache, altered sensorium and unsteadiness of gait. Neurological evaluation revealed a drowsy patient with papilloedema, bilateral lateral rectus palsy, generalised hyper-reflexia and up going plantar responses. Urgent imaging performed showed extensive cortical venous sinus thrombosis. Workup for secondary causes of cortical venous sinus thrombosis revealed very high titres of antinuclear antibody and anti-dsDNA, but negative antiphospholipid antibodies (APLA). In hospital she started developing other complications of systemic lupus erythematosus (SLE). Urine evaluation revealed proteinuria and granular casts suggestive of glomerulonephritis. Cardiac evaluation revealed moderate pericardial effusion. We have discussed neurolupus as initial presentation of SLE and the rare occurrence of major neurovascular complications without secondary APLA syndrome. |
| doi_str_mv | 10.1136/bcr-2014-205355 |
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Neurological evaluation revealed a drowsy patient with papilloedema, bilateral lateral rectus palsy, generalised hyper-reflexia and up going plantar responses. Urgent imaging performed showed extensive cortical venous sinus thrombosis. Workup for secondary causes of cortical venous sinus thrombosis revealed very high titres of antinuclear antibody and anti-dsDNA, but negative antiphospholipid antibodies (APLA). In hospital she started developing other complications of systemic lupus erythematosus (SLE). Urine evaluation revealed proteinuria and granular casts suggestive of glomerulonephritis. Cardiac evaluation revealed moderate pericardial effusion. 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Neurological evaluation revealed a drowsy patient with papilloedema, bilateral lateral rectus palsy, generalised hyper-reflexia and up going plantar responses. Urgent imaging performed showed extensive cortical venous sinus thrombosis. Workup for secondary causes of cortical venous sinus thrombosis revealed very high titres of antinuclear antibody and anti-dsDNA, but negative antiphospholipid antibodies (APLA). In hospital she started developing other complications of systemic lupus erythematosus (SLE). Urine evaluation revealed proteinuria and granular casts suggestive of glomerulonephritis. Cardiac evaluation revealed moderate pericardial effusion. We have discussed neurolupus as initial presentation of SLE and the rare occurrence of major neurovascular complications without secondary APLA syndrome.</description><subject>Adult</subject><subject>Antibodies, Antiphospholipid - immunology</subject><subject>Black</subject><subject>Cardiac arrhythmia</subject><subject>Cerebral Angiography</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Fever</subject><subject>Hematoma, Subdural - diagnosis</subject><subject>Hematoma, Subdural - etiology</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>Immunoglobulins</subject><subject>Intracranial Thrombosis - diagnosis</subject><subject>Intracranial Thrombosis - etiology</subject><subject>Lupus</subject><subject>Lupus Erythematosus, Systemic - complications</subject><subject>Lupus Erythematosus, Systemic - diagnosis</subject><subject>Lupus Erythematosus, Systemic - immunology</subject><subject>Medical imaging</subject><subject>Middle East</subject><subject>Patients</subject><subject>Phlebography - methods</subject><subject>Sinuses</subject><subject>Thrombosis</subject><subject>Tomography, X-Ray Computed</subject><subject>Unusual Presentation of More Common Disease/Injury</subject><subject>Urine</subject><subject>Venous Thrombosis - diagnosis</subject><subject>Venous Thrombosis - etiology</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFks2L1DAYxoso7rLu2ZsEvIgwbj6b9CLIoLvCgpc9eAtJ-3aaoW1q3nZk_hn_VjMzu8vqQQP5an55kid9iuI1ox8YE-WVr9OKUyZzo4RSz4pzppVe6Yp-f_5kfFZcIm5pLoJJI8XL4owraqiS5rz4tYYEPrme7GCMC5K5S3HwEQOSKQHCOIdxQ36GuSO4-GY5oJ2Dwc1xcMQhaUPC-YF1c4gjaWMiuMcZhlCTfpmyLKT93B13YZ4d5UbYZHwHxOUzpi5irn2YQnP84GMTAF8VL1rXI1ze9xfF3ZfPd-ub1e2366_rT7crL8tKraSsRW0qzaWopM_OlTeypAqMb8C3otQKHK1MnrKqFMqUrKGa-YZXuq5acVF8PMlOix-gqbOT7NNOKQwu7W10wf65MobObuLOSsbzs_Is8O5eIMUfC-Bsh4A19L0bIb-qZUoxynnJyoy-_QvdxiWN2Z1lhpfaHP_UvyhtBNfKsMOxVyeqThExQft4ZUbtISM2Z8QeMmJPGck73jx1-sg_JCID70-AH7b_VfsN5qvJGg</recordid><startdate>20140730</startdate><enddate>20140730</enddate><creator>Alboudi, Ayman</creator><creator>Sarathchandran, Pournamy</creator><creator>Alrukn, Suhail</creator><creator>Al Madani, Abubaker</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140730</creationdate><title>Cerebral venous thrombosis presenting with subdural haematoma as first presentation for systemic lupus erythematosus with negative antiphospholipid antibodies</title><author>Alboudi, Ayman ; Sarathchandran, Pournamy ; Alrukn, Suhail ; Al Madani, Abubaker</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b4695-44c3c89724394b1755b84605e8bdebf3675ea0988bd19635861d071bd297c9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Antibodies, Antiphospholipid - immunology</topic><topic>Black</topic><topic>Cardiac arrhythmia</topic><topic>Cerebral Angiography</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Fever</topic><topic>Hematoma, Subdural - diagnosis</topic><topic>Hematoma, Subdural - etiology</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>Immunoglobulins</topic><topic>Intracranial Thrombosis - diagnosis</topic><topic>Intracranial Thrombosis - etiology</topic><topic>Lupus</topic><topic>Lupus Erythematosus, Systemic - complications</topic><topic>Lupus Erythematosus, Systemic - diagnosis</topic><topic>Lupus Erythematosus, Systemic - immunology</topic><topic>Medical imaging</topic><topic>Middle East</topic><topic>Patients</topic><topic>Phlebography - methods</topic><topic>Sinuses</topic><topic>Thrombosis</topic><topic>Tomography, X-Ray Computed</topic><topic>Unusual Presentation of More Common Disease/Injury</topic><topic>Urine</topic><topic>Venous Thrombosis - diagnosis</topic><topic>Venous Thrombosis - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alboudi, Ayman</creatorcontrib><creatorcontrib>Sarathchandran, Pournamy</creatorcontrib><creatorcontrib>Alrukn, Suhail</creatorcontrib><creatorcontrib>Al Madani, Abubaker</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alboudi, Ayman</au><au>Sarathchandran, Pournamy</au><au>Alrukn, Suhail</au><au>Al Madani, Abubaker</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral venous thrombosis presenting with subdural haematoma as first presentation for systemic lupus erythematosus with negative antiphospholipid antibodies</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2014-07-30</date><risdate>2014</risdate><volume>2014</volume><spage>bcr2014205355</spage><pages>bcr2014205355-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>We report the case of a 30-year-old woman, without any previous comorbidities presenting with acute onset headache, altered sensorium and unsteadiness of gait. Neurological evaluation revealed a drowsy patient with papilloedema, bilateral lateral rectus palsy, generalised hyper-reflexia and up going plantar responses. Urgent imaging performed showed extensive cortical venous sinus thrombosis. Workup for secondary causes of cortical venous sinus thrombosis revealed very high titres of antinuclear antibody and anti-dsDNA, but negative antiphospholipid antibodies (APLA). In hospital she started developing other complications of systemic lupus erythematosus (SLE). Urine evaluation revealed proteinuria and granular casts suggestive of glomerulonephritis. Cardiac evaluation revealed moderate pericardial effusion. We have discussed neurolupus as initial presentation of SLE and the rare occurrence of major neurovascular complications without secondary APLA syndrome.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25080548</pmid><doi>10.1136/bcr-2014-205355</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Antibodies, Antiphospholipid - immunology Black Cardiac arrhythmia Cerebral Angiography Diagnosis, Differential Female Fever Hematoma, Subdural - diagnosis Hematoma, Subdural - etiology Humans Imaging, Three-Dimensional Immunoglobulins Intracranial Thrombosis - diagnosis Intracranial Thrombosis - etiology Lupus Lupus Erythematosus, Systemic - complications Lupus Erythematosus, Systemic - diagnosis Lupus Erythematosus, Systemic - immunology Medical imaging Middle East Patients Phlebography - methods Sinuses Thrombosis Tomography, X-Ray Computed Unusual Presentation of More Common Disease/Injury Urine Venous Thrombosis - diagnosis Venous Thrombosis - etiology |
| title | Cerebral venous thrombosis presenting with subdural haematoma as first presentation for systemic lupus erythematosus with negative antiphospholipid antibodies |
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