Affiliations 

  • 1 University Malaya Eye Research Centre, Ophthalmology Department, Faculty of Medicine, University of Malaya, Malaysia
  • 2 Clinical Research Centre, Management and Science University, Seksyen 13, 40100, Shah Alam, Selangor, Malaysia
  • 3 Radiology Department, Faculty of Medicine, Universiti Teknologi MARA, Sungai buloh, Selangor, Malaysia
  • 4 Medical Department, Faculty of Medicine, Universiti Teknologi MARA, Sungai buloh, Selangor, Malaysia
Eur J Ophthalmol, 2020 Oct 19.
PMID: 33070639 DOI: 10.1177/1120672120965499

Abstract

BACKGROUND: Deep cerebral venous sinus thrombosis is a reversible yet potentially serious thromboembolic event. A number of reports suggest a relationship between long-haul flights and thromboembolic events, mainly deep venous thrombosis (DVT) and pulmonary embolism (PE). It is rarely reported to cause deep cerebral venous sinus thrombosis. We report a case of a bilateral papilledema after long-haul flight secondary to deep cerebral venous sinus thrombosis with subsequent complete recovery post corticosteroid and anticoagulant therapy.

CASE: A case of a 21-year-old woman with no known medical illness who presented with gradual painless bilateral visual loss is described. She had a history of travelling on a long-haul flight 3 weeks prior to presentation. Examination showed presence of bilateral papilloedema, no vitritis, choroiditis and retinitis. Blood investigations showed raised international normalised ratio (INR). Otherwise, workup for infectious causes of optic disc swelling, connective tissue disease screening were normal. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) of the brain showed loss of flow signal in the right transverse sinus and the left sigmoid sinus. Blood workup for preexisting hypercoagulable state was normal. She was diagnosed with deep cerebral venous sinus thrombosis and showed complete recovery with oral corticosteroid and anticoagulant therapy.

CONCLUSION: Deep cerebral venous sinus thrombosis is a potentially serious consequence of long-haul flights. A high index of suspicion along with radiological techniques is needed for early detection and initiation of anticoagulation for this reversible condition.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.