Intracranial Hypotension Syndrome Combined with Intracranial Venous Si-nus Thrombosis Misdiagnosed as Migraine:A Case Report and Literature Review
Objective To investigate the causes of misdiagnosis of intracranial hypotension syndrome combined with intracranial venous sinus thrombosis as migraine,and to summarize preventive measures for misdiagnosis.Methods The clinical data of a patient with intracranial hypotension syndrome combined with intracranial venous sinus thrombosis misdiag-nosed as migraine were retrospectively analyzed.Results A 51-year-old female patient presented with migraine when she was admitted to hospital.After completing lumbar puncture,intracranial hypotension headache(IHH)appeared,the effect of flu-id therapy was poor,the headache was aggravated,the features of orthostatic headache disappeared,and it was misdiagnosed as migraine recurrence.After magnetic resonance angiography and magnetic resonance venography,combined with the symp-toms of the patient,the diagnosis of intracranial hypotension syndrome combined with intracranial venous sinus thrombosis was confirmed.The misdiagnosis lasted 15 d.He was treated with anticoagulation and intracranial pressure reduction and dis-charged from hospital.The international standardized ratio was monitored in the outpatient follow-up after discharge.Enhanced head magnetic resonance venous imaging(MRI)scan was re-examined 3 months afterwards,indicating that the intracranial venous sinus thrombosis disappeared completely and the patient's headache was relieved.Conclusion IHH is one of the most common complications after lumbar puncture.The possibility of intracranial venous sinus thrombosis should be considered when headache becomes non-postural or persistent severe headache occurs.In order to avoid misdiagnosis,it is necessary to collect the medical history in detail,be alert to abnormal examination results contrary to the patient's symptoms,search for re-lated causes,conduct targeted examination in time,carefully read the film to rule out other diseases,and improve the differen-tiation ability of clinicians in the diagnosis and treatment of headache and the vigilance of severe causes.
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