Delay in diagnosis of cerebral venous and sinus thrombosis: successful use of anticoagulation treatment. case report

Since its debut in the 1960s, the broad use and availability of benzodiazepines has mirrored the increased incidence of overdose cases. Due to its non-specic presentation, there is often a delay in diagnosis. We report a case of Benzodiazepine toxicity in a 70-year-old man who presented to us in a comatose state. He was evaluated at another hospital initially and was intubated in view of his low Glasgow Coma scale. A CT brain plain study was done suspecting a basilar artery thrombus and he was referred to us for Neuro-Interventional procedures. As radiological, laboratory and electrophysiological investigations were unremarkable a provisional diagnosis of drug intoxication was made after patient medication review and a trial of Flumazenil was given, after which the patient had improved dramatically. Flumazenil is not routinely used due to fears of withdrawal seizures and its high cost. It also has no effect on reversing sedation caused by barbiturates, ethanol, or opioids. The antidote has a favorable risk-benet ratio when dosed appropriately and can be a helpful diagnostic tool after ruling out the more common causes of acute sensorium loss as demonstrated by this case report.

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Surgical corridors for congenital aural atresia with otogenic cerebellar abscess and lateral sinus thrombosis

BMJ Case Reports ◽

10.1136/bcr-2020-239403 ◽

2021 ◽

Vol 14 (5) ◽

pp. e239403

Author(s):

Saranya Thangavel ◽

Lokesh Kumar Penubarthi ◽

Arun Alexander ◽

Sunil Kumar Saxena

Keyword(s):

Case Report ◽

Facial Palsy ◽

Multidisciplinary Approach ◽

Sinus Thrombosis ◽

Lateral Sinus ◽

Aural Atresia ◽

Lateral Sinus Thrombosis ◽

Cerebellar Abscess ◽

Intracranial Complications ◽

Congenital Aural Atresia

The following is a case report of an adolescent with mental retardation who had congenital aural atresia with contralateral congenital facial palsy. She developed multiple intracranial complications (cerebellar abscess and lateral sinus thrombosis) due to cholesteatoma. We managed her in a multidisciplinary approach. This report discusses case management, emphasising the meticulous intraoperative steps taken in identifying the landmarks and precautions adopted to avoid postoperative facial palsy and other complications.

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Catatonia, beyond a psychiatric syndrome

Dementia & Neuropsychologia ◽

10.1590/1980-57642016dn11-020015 ◽

2017 ◽

Vol 11 (2) ◽

pp. 209-212

Author(s):

Nathália Stela Visoná de Figueiredo ◽

Débora Bartzen Moraes Angst ◽

Antônio de Matos Lima Neto ◽

Michel Ferreira Machado ◽

Maria Sheila Guimarães Rocha ◽

...

Keyword(s):

Case Report ◽

Status Epilepticus ◽

Clinical Manifestation ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Nonconvulsive Status Epilepticus ◽

Diagnostic Investigation ◽

Venous Sinus Thrombosis ◽

Psychiatric Syndrome

ABSTRACT Although catatonia is a well-known psychiatric syndrome, there are many possible systemic and neurological etiologies. The aim of this case report was to present a case of a patient with cerebral venous sinus thrombosis and infarction in which catatonia was the clinical manifestation of a possible nonconvulsive status epilepticus. To our knowledge, only one such case has been reported in the literature, which had a simplified diagnostic investigation. It is important to correctly recognize the organic cause underlying catatonia in order to treat the patient as soon as possible thereby improving outcome. Therefore, physicians need to update their knowledge on catatonia, recognizing that it can be part of a psychiatric or neurologic condition.

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