This is a case report of superior sagittal sinus thrombosis (SSST), with
bilateral papilledema as the initial manifestation.
A 65-year-old male was referred to us with bilateral decreased vision and recurrent
blackouts associated with postural change. Although his intracranial pressure was
increased, an intracranial space-occupying lesion was not detected by computed
tomography (CT). Magnetic resonance imaging (MRI) with a fluid-attenuated inversion
recovery (FLAIR) technique and magnetic resonance venography (MRV) findings
revealed a thrombosed superior sagittal sinus. Anticoagulation therapy with heparin
was started and recurrent blackouts disappeared one month thereafter.
Thoracoabdominal CT examination revealed an infiltrative shadow in the right inferior
lobe of the lungand was diagnosed as squamous cell carcinoma from biopsy by
bronchoscopy. Bilateral papilledema gradually decreased over an 18-month
observation period after anticoagulation therapy.
MRV was useful in the diagnosis of SSST in this case of bilateral papilledema with
increased intracranial pressure.
Keywords: Cerebral venous sinus thrombosis, Magnetic resonance venography,
Papilledema, Recurrent blackouts, Squamous cell carcinoma.
