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Ranjodh Singh, William P. Cope, Zhiping Zhou, Michelle E. De Witt, John A. Boockvar and Apostolos J. Tsiouris

, Kara B , Ipek H , Ozbayrak M , Kantarci F : Isolated cortical venous thrombosis associated with intracranial hypotension syndrome . Headache 49 : 916 – 919 , 2009 2 Albayram S , Tasmali KM , Gunduz A : Can spontaneous intracranial hypotension cause venous sinus thrombosis? . J Headache Pain 8 : 200 – 201 , 2007 3 Bittencourt LK , Palma-Filho F , Domingues RC , Gasparetto EL : Subarachnoid hemorrhage in isolated cortical vein thrombosis: rare presentation of an unusual condition . Arq Neuropsiquiatr 67 : 1106 – 1108

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R. Loch Macdonald

two can overlap. Cases of subarachnoid hemorrhage due to isolated cortical vein thrombosis are described. 4 The diagnosis has sometimes been delayed or missed due to its rarity and to the varied clinical presentations. Saposnik and colleagues 13 reviewed treatment for CVST. It was considered reasonable to treat these patients in a stroke unit. The main treatment for CVST is anticoagulation. A meta-analysis of 2 randomized trials of anticoagulants found that although this treatment was relatively safe, there was only a statistically insignificant reduction in

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J. Nicole Bentley, Ramón E. Figueroa and John R. Vender

thoroughly and discern who requires further workup. Although not specific for CVT, different sources report the incidence of some signs and symptoms that can be helpful in localization. Visual impairment occurs in 10–13% of patients and papilledema in 27–80% and can point to thrombus in the cavernous sinus; focal deficits have been reported in 27–79% and are suggestive of isolated cortical vein thrombosis. Superior sagittal sinus thrombosis can cause seizures, which has been observed in 10–63% of patients, and coma was the presenting symptom in 15%, pointing to

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Avital Perry, Christopher S. Graffeo, Waleed Brinjikji, William R. Copeland III, Alejandro A. Rabinstein and Michael J. Link

112 : 498 – 500 , 2010 10.1016/j.clineuro.2010.01.010 20399554 20 Kataoka H , Tanizawa E , Ueno S : Spontaneous intracranial hypotension is associated with a risk of venous sinus thrombosis and subdural hematoma . Cerebrovasc Dis 23 : 315 – 317 , 2007 10.1159/000098446 17213717 21 Lai PH , Li JY , Lo YK , Wu MT , Liang HL , Chen CK : A case of spontaneous intracranial hypotension complicated by isolated cortical vein thrombosis and cerebral venous infarction . Cephalalgia 27 : 87 – 90 , 2007 10.1111/j.1468-2982.2007.01235.x