TY - JOUR
T1 - Paradoxical presentation of orthostatic headache associated with increased intracranial pressure in patients with cerebral venous thrombosis
AU - Kim, Jung B.
AU - Kwon, Do Young
AU - Park, Moon Ho
AU - Kim, Byung Jo
AU - Park, Kun Woo
PY - 2013/1
Y1 - 2013/1
N2 - Headache is the most common symptom of cerebral venous thrombosis (CVT); however, the detailed underlying mechanisms and characteristics of headache in CVT have not been well described. Here, we report two cases of CVT whose primary and lasting presentation was orthostatic headache, suggestive of decreased intracranial pressure. Contrary to our expectations, the headaches were associated with elevated cerebrospinal fluid (CSF) pressure. Magnetic resonance imaging and magnetic resonance venography showed characteristic voiding defects consistent with CVT. We suggest that orthostatic headache can be developed in a condition of decreased intracranial CSF volume in both intracranial hypotensive and intracranial hypertensive states. In these cases, orthostatic headache in CVT might be caused by decreased intracranial CSF volume that leads to the inferior displacement of the brain and traction on pain-sensitive intracranial vessels, despite increased CSF pressure on measurement. CVT should be considered in the differential diagnosis when a patient complains of orthostatic headache.
AB - Headache is the most common symptom of cerebral venous thrombosis (CVT); however, the detailed underlying mechanisms and characteristics of headache in CVT have not been well described. Here, we report two cases of CVT whose primary and lasting presentation was orthostatic headache, suggestive of decreased intracranial pressure. Contrary to our expectations, the headaches were associated with elevated cerebrospinal fluid (CSF) pressure. Magnetic resonance imaging and magnetic resonance venography showed characteristic voiding defects consistent with CVT. We suggest that orthostatic headache can be developed in a condition of decreased intracranial CSF volume in both intracranial hypotensive and intracranial hypertensive states. In these cases, orthostatic headache in CVT might be caused by decreased intracranial CSF volume that leads to the inferior displacement of the brain and traction on pain-sensitive intracranial vessels, despite increased CSF pressure on measurement. CVT should be considered in the differential diagnosis when a patient complains of orthostatic headache.
KW - Cerebral venous thrombosis
KW - Cerebrospinal fluid
KW - Intracranial pressure
KW - Orthostatic headache
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U2 - 10.4103/0972-2327.107705
DO - 10.4103/0972-2327.107705
M3 - Article
C2 - 23661970
AN - SCOPUS:84875698835
VL - 16
SP - 85
EP - 87
JO - Annals of Indian Academy of Neurology
JF - Annals of Indian Academy of Neurology
SN - 0972-2327
IS - 1
ER -