Intracerebral haemorrhage due to cerebral venous sinus thrombosis

Sir, Cerebral venous sinus thrombosis (CVST) is a common cause of stroke in young in India especially during post-partum period.1 It has diverse clinical presentations including headache, seizures and focal neurological deficit in various combinations. In the causes of intracerebral haemorrhage (ICH), CVST is not mentioned in standard text. A Medline search using terms ICH and CVST revealed only four articles comprising of eight patients.2–5 In last 3 years we have managed 33 patients with CVST and three of them had ICH and were initially misdiagnosed as aneurysmal or arteriovenous venous malformation (AVM) bleed. We report these patients and review the contemporary literature. A 65-year-old female presented with sudden onset of left sided headache for first time in life 2 weeks back associated with vomiting. For 2 days she was unable to recognize her relatives and gradually became comatose. Her blood pressure was 120/86 mm of Hg and Glasgow Coma Scale (GCS) score 7. She had bilateral papilloedema. There was no focal weakness. Tendon reflexes were brisk and plantar bilaterally extensor. Her systemic examination was normal. …