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Pontine infarction due to intracranial venous thrombosis

Clinical Lecturers in Neurology, Division of Neuroscience, University of Liverpool, Clinical Sciences Centre, Liverpool, UK
Consultant Neuroradiologist, Walton Centre for Neurology & Neurosurgery, Liverpool, UK
Consultant Neurologist, Walton Centre for Neurology & Neurosurgery, Liverpool, UK

Correspondence to:
Dr H C A Emsley, Division of Neuroscience, University of Liverpool, Clinical Sciences Centre, Lower Lane, Liverpool L9 7LJ, UK; h.emsley@liv.ac.uk

The first 150 words of the full text of this article appear below.

A 30-year-old woman presented to her local hospital with an abrupt onset of left-sided headache and retro-orbital pain, dizziness, unsteadiness, vomiting, dysarthria, right facial paresis and right hemiparesis. She was otherwise well, and taking the oral contraceptive pill. MR brain imaging showed high signal intensity in the left pons (fig 1) and MR venography showed evidence of left sigmoid sinus and proximal internal jugular vein thrombosis (figs 2 and 3). She was anticoagulated with unfractionated iv heparin followed by warfarin. Her symptoms gradually improved. An abrupt but transient worsening of her right hemiparesis 10 days after the initial onset prompted transfer to our centre, but there was no haemorrhage on brain CT or new infarction on repeat MRI. In fact, the repeat MRI and MRV showed recanalisation in both the sigmoid sinus and proximal internal jugular vein (figs 2 and 3), but persistence of . . . [Full text of this article]