Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies

Byju, N; Jose, James; Saifudheen, K; Gafoor, V Abdul; Jithendranath, P

doi:10.4103/0972-5229.106505

Cited by 9 publications

(10 citation statements)

References 7 publications

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“…As previously reported, the venous thrombosis around the jugular foramen can be cause of the lower cranial nerve paralysis. Several authors reported the paralysis of cranial nerves IX, X, XI, XII was caused by the thrombosis of the sigmoid-jugular complex similar to our case [29,30,31]. As well as thrombosis of the jugular foramen, jugular foramen shwannomas can present paralysis of CNs IX to XII.…”

Section: Discussionsupporting

confidence: 83%

Malignant perivascular epithelioid cell tumor mimicking jugular foramen schwannoma: A case report and literature review

Komune

Masuda

Yasumatsu

et al. 2020

Heliyon

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Background: Perivascular epithelioid cell tumors (PEComas) of the skull base are extremely rare. Here we report the first description of a malignant PEComa mimicking jugular foramen schwannoma and presenting as Collet-Sicard syndrome, and we review the previous literature on PEComas of the head, neck and skull base. Case description: A 29-year-old woman presented with hoarseness, dysphagia, vomiting, and headache. She was first diagnosed with Collet-Sicard syndrome caused by thrombosis of the sigmoid and transverse sinuses. She was treated with anticoagulant therapy, and the hoarseness and paralysis of the accessory nerve improved. Later, at age 31, the hoarseness again worsened. At another hospital, enhanced computed tomography revealed a tumor in the jugular foramen extending to the neck and medially displacing the internal carotid artery. She was referred to our hospital for further examination and was diagnosed with jugular foramen schwannoma causing thrombosis of the sinuses. At the one-year follow-up, the tumor had grown rapidly and had started to surround the internal carotid artery. We therefore performed a tissue biopsy of the tumor in the jugular foramen and neck. Based on pathological analysis, we made a definitive diagnosis of malignant PEComa. Conclusions: It may be extremely challenging to reach an accurate diagnosis of PEComa in the skull-base region, which can cause a delay in treatment initiation. When atypical clinical features for a skull-base tumor are found, we recommend preliminary biopsy to obtain a definitive diagnosis and initiate an appropriate treatment strategy as early as possible.

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Section: Discussionsupporting

confidence: 83%

Malignant perivascular epithelioid cell tumor mimicking jugular foramen schwannoma: A case report and literature review

Komune

Masuda

Yasumatsu

et al. 2020

Heliyon

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“…Posterior group cranial nerves can also be involved in CVT. Byju et al ( 2012 ) reported a case of a pregnant woman who showed right sensory nerve deafness and IX, X, and XII cranial nerve paralysis on the right side. She was diagnosed with thrombosis of the right transverse sinus and sigmoid sinus stretching into the deep jugular vein and torcular herophili, and her symptoms improved after anticoagulation treatment.…”

Section: Clinical Featuresmentioning

confidence: 99%

Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Luo

Tian

Wang

2018

Front. Aging Neurosci.

123

145

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Cerebral venous thrombosis (CVT), also called cerebral venous sinus thrombosis (CVST), is a cerebrovascular disease with diverse clinical manifestations that often affects young adults, women of childbearing age, and children. It's most common clinical manifestations are headache, seizures, altered consciousness, and neurological focal signs on physical examination. CVT can manifest as a single symptom, or it can present as a syndrome consisting of multiple symptoms. This non-specific clinical picture makes diagnosing CVT difficult. Although the mortality rate of CVT has been significantly reduced by improvements in treatment and diagnostic techniques, the mortality rate of severe CVT remains as high as 34.2%. Survivors of this type of CVT have varying degrees of residual symptoms and are not able to return to their previous work. Hence, we performed a comprehensive literature search in the PubMed, EMBASE, and Medline databases to review the diagnosis and treatment of CVT.

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“…In addition, it helped the researchers in understanding the medical history of the patient. Case history also provided information on tinnitus, which is a frequent complaint after CVST [ 11 ]. On oral peripheral mechanism examination, it was clear that Ms. X had normal structure and function of articulators.…”

Section: Discussionmentioning

confidence: 99%

“…Speech disturbances were indicated in superior sinus thrombosis with a small venous infarct [ 6 ], intracranial hypertension in occlusions of lateral sinus [ 7 ], aphasia in occlusions of the left transverse sinus [ 8 ], posterior alexia in sigmoid sinus thrombosis [ 9 ], and acute micrographia and hypophonia in case of deep venous sinus thrombosis [ 10 ]. Other characteristics observed were slurred speech, hoarseness, nasal twang, swallowing difficulties, restricted functions of articulators, tinnitus, unilateral hearing problems, and depressed levels of consciousness [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Test Battery Approach to Assess an Individual with Cerebral Venous Sinus Thrombosis: A Speech Language Pathologist’s Perspective

Varghese¹,

A²

2021

Case Rep Neurol

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Cerebral venous sinus thrombosis (CVST) is an uncommon stroke that has a varied clinical profile. Quite often, speech language pathologists limit the assessment of these patients to a language assessment alone. Subsequently, it is possible that they may miss out certain relevant information which can aid them in their intervention. The aim of the current study was to highlight the relevance of adopting a test battery approach to assess a patient diagnosed with CVST. Here, we present a test battery approach to assess a 43-year-old patient who reported to us after CVST. The test battery included various formal and informal measures. Apart from the routine measures, an additional test for assessing the cognitive linguistic profile was included in the battery which yielded us significant information regarding the patient. Thus, we concluded that speech language pathologists should follow a test battery approach to get a clear idea about the clinical profile of the patient, to avoid misdiagnosis, and also to provide suitable intervention.

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Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies

Cited by 9 publications

References 7 publications

Malignant perivascular epithelioid cell tumor mimicking jugular foramen schwannoma: A case report and literature review

Malignant perivascular epithelioid cell tumor mimicking jugular foramen schwannoma: A case report and literature review

Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review

Test Battery Approach to Assess an Individual with Cerebral Venous Sinus Thrombosis: A Speech Language Pathologist’s Perspective

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