HYPERHOMOCYSTEINEMIA AND CORTICAL VENOUS THROMBOSISA CASE REPORT

N a missed diagnosis unless you look for it. It is due to occlusion of cortical veins draining the brain. It constitutes 0.5 of all strokes. The aetiology of CVT is vast and can be classified into infectious, noninfectious causes. Unless actively intervened, its devastating due to increased intracranial tension. We discuss here, a case of cortical venous thrombosis with hyperhomocysteinemia. We evaluated for other causes but results are inconclusive of any other aetiology. Hyperhomocysteinemia has been associated with CVT. Severe headache is the usual presenting complaints, followed by seizures and altered sensorium. CT brain can demonstrate classical delta sign. MRI with T1, T2, fluid-attenuated inversion recovery and T2 (echo planar) sequences with Magnetic resonance angiography will pick up the extent of lesion and useful in diagnosing and treating the patients. Regarding management there are various controversies for fibrinolysis, anticoagulation, mechanical fibrinolectomy and surgery. But, still anti-coagulation withheparin remains primary treatment in managing acute cases.