We read with interest the article by Savage and Harrison on deep cerebral venous thrombosis (DCVT) misdiagnosed as eclampsia in an emergency department.1 Cerebral venous thrombosis is estimated to occur in 3–4 persons per 1 million of the population per year. In 3–8% of these patients the deep cerebral veins (vein of Rosenthal, internal vein and vein of Galen) are affected by the thrombosis.2 3 Patients with DCVT often present with rapid worsening of clinical signs and symptoms until they reach a comatose state, often accompanied by long tract signs.3 As prognosis largely depends on early diagnosis and treatment, rapid and accurate diagnosis is mandatory. We present two patients with DCVT who were initially misdiagnosed as having thalamic and basal ganglia tumours.

Case 1

A 25-year-old healthy woman with an unremarkable history presented to the emergency department of her local hospital with a muzzy headache and slurred speech after an amateur football …