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Table 1 Timeline of the patient and case

From: Cerebral venous sinus thrombosis in a young female misdiagnosed as migraine ending in a permanent vegetative state: a case report and review of the literature

Date

 
 

Past medical history

22-7-2017

35-year-old female, who was previously healthy, and has positive family history of stroke at a young age

 

Summaries from initial and follow up visits

Diagnostic testing

Intervention

22-7-2017

Throbbing headache for the past 2 days

Diagnosed as migraine

None was obtained

Analgesics: diclofenac injection, discharged on oral ibuprofen.

23-7-2017

05:00

The same headache that continued for 3 days

CBC, RFT, LFT, PT, PTT, and INR: within normal range;

Plain CT of the head: hyperdense area in the SSS; CVST

 

23-7-2017

09:00

 

CT of the head with contrast confirmed the diagnosis of CVST

Admission to a regular ward; LMWH

23-7-2017

06:30

Decrease level of consciousness

Talking, a few words inappropriately

Repeat plain CT head scan: third ventricular hemorrhage and deep venous thrombosis

Elective intubation; ICU admission; continue LMWH; EVD insertion (a few hours later)

25-7-2017

The same condition; no improvement

Repeat CT head scan: hydrocephalous and increasing edema and new ischemic areas

Brain decompression

31-7-2017

Left pupil dilatation

CT head scan: large hemorrhage

Evacuation, enoxaparin switched to unfractionated heparin

To date

In the ICU; on tracheostomy with mechanical ventilation; in a permanent vegetative state; need for long-term care

  1. CBC complete blood count, CT computed tomography, CVST cerebral venous sinus thrombosis, EVD extraventricular drain, ICU intensive care unit, INR international normalized ration, LFT liver function test, LMWH low-molecular weight heparin, PT prothrombin time, PTT partial thromboplastin time, RFT renal function tast, SSS superior sagittal sinus