IMAGES IN EMERGENCY MEDICINE
Coma from cerebral venous thrombosis: an overlooked cause
Kingdom Hospital, PO Box 84400, Riyadh, Saudi Arabia
Correspondence to:
Dr A Debek, Kingdom Hospital, PO Box 84400, Riyadh 11671, Saudi Arabia; alidebek@yahoo.com
Accepted 3 November 2007
| The first 150 words of the full text of this article appear below. |
A 37-year-old man with an unremarkable past medical history was brought to the emergency department by ambulance after being found in a coma state. After initial evaluation and stabilisation including intubation, investigations to identify the cause(s) of this coma state were carried out. On physical examination, the patient was afebrile, haemodynamicaly stable, with no evidence of trauma; neurologically there was no neck stiffness, he had slightly miotic but reactive pupils (size 2–3), there was localisation of painful stimuli but no clear neuromotor deficit. Initial laboratory tests including urinary toxin screening, complete blood count, serum electrolytes, liver function tests, calcium, magnesium, erythrocyte sedimentation rate, C-reactive protein and cardiac enzymes were all within normal limits except for a slightly elevated blood sugar level of 220 mg/dl. Chest x ray and electrocardiogram did not reveal abnormalities. An initial brain computed tomography scan was normal. The patient was suspected of having had a stroke
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Clinical diagnostic tests
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Radiology (diagnostics)
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Coma and raised intracranial pressure
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