A case of convexity non‐aneurysmal subarachnoid hemorrhage caused by cerebral sinus thrombosis
Dublin Core
Title
A case of convexity non‐aneurysmal subarachnoid hemorrhage caused by cerebral sinus thrombosis
Subject
Subarachnoid hemorrhage, Cerebral sinus thrombosis, Case report, Convexity SAH
Description
Abstract
Background Convexity subarachnoid hemorrhage (cSAH) is an uncommon presentation of subarachnoid bleeding,
referring to bleeding more localized to the convexities of the brain. The diagnosis of cerebral venous sinus thrombo-
sis (CVST) can be difficult especially when patients initially present with cSAH. The authors present a case and then
discuss the pathophysiology and management.
Case presentation A 56-year-old woman with a previous history of hypertension and ischemic heart disease pre-
sented to the emergency department after experiencing it. Two seizures following a severe headache. The patient’s
history was negative for recent illnesses, head trauma, history of migraines, smoking, alcohol consumption, or intra-
venous drug use. The patient was diagnosed with CVST based on magnetic resonance venography (MRV). Genetic
studies further identified homozygous mutations in the Prothrombin and MTHFR genes. Anticoagulant therapy
was initiated with 60 mg of Enoxaparin twice daily and subsequently transitioned to Warfarin after 48 h continued
for 3 months, and then replaced by rivaroxaban.
Conclusions This study highlights the importance of considering CVST as a cause of SAH, emphasizes the role
of advanced imaging in diagnosis, and demonstrates a successful treatment approach using both traditional
and direct oral anticoagulants. The insights provided in this article can contribute to improving the management
of patients with CVST-related SAH.
Keywords Subarachnoid hemorrhage, Cerebral sinus thrombosis, Case report, Convexity SAH
Background Convexity subarachnoid hemorrhage (cSAH) is an uncommon presentation of subarachnoid bleeding,
referring to bleeding more localized to the convexities of the brain. The diagnosis of cerebral venous sinus thrombo-
sis (CVST) can be difficult especially when patients initially present with cSAH. The authors present a case and then
discuss the pathophysiology and management.
Case presentation A 56-year-old woman with a previous history of hypertension and ischemic heart disease pre-
sented to the emergency department after experiencing it. Two seizures following a severe headache. The patient’s
history was negative for recent illnesses, head trauma, history of migraines, smoking, alcohol consumption, or intra-
venous drug use. The patient was diagnosed with CVST based on magnetic resonance venography (MRV). Genetic
studies further identified homozygous mutations in the Prothrombin and MTHFR genes. Anticoagulant therapy
was initiated with 60 mg of Enoxaparin twice daily and subsequently transitioned to Warfarin after 48 h continued
for 3 months, and then replaced by rivaroxaban.
Conclusions This study highlights the importance of considering CVST as a cause of SAH, emphasizes the role
of advanced imaging in diagnosis, and demonstrates a successful treatment approach using both traditional
and direct oral anticoagulants. The insights provided in this article can contribute to improving the management
of patients with CVST-related SAH.
Keywords Subarachnoid hemorrhage, Cerebral sinus thrombosis, Case report, Convexity SAH
Creator
Ali Abasi1
, Asra Moradkhani1
, Shiva Rahimi2 and Hannah Magrouni2*
, Asra Moradkhani1
, Shiva Rahimi2 and Hannah Magrouni2*
Source
https://doi.org/10.1186/s12245-024-00712-3
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Ali Abasi1
, Asra Moradkhani1
, Shiva Rahimi2 and Hannah Magrouni2*, “A case of convexity non‐aneurysmal subarachnoid hemorrhage caused by cerebral sinus thrombosis,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12437.