Cerebral Venous Thrombosis Presenting With Binocular Blindness and Bilateral Sensorineural Hearing Loss

TL;DR

A 27-year-old woman developed blindness and hearing loss due to a rare type of stroke called cerebral venous thrombosis.

Contribution

The paper presents a rare clinical case of CVT with unusual symptoms of bilateral blindness and hearing loss.

Findings

The patient exhibited bilateral sensorineural hearing loss and blindness alongside typical CVT symptoms.

Imaging confirmed thrombosis in the posterior superior sagittal sinus and subarachnoid hemorrhage.

Hearing and eye movement issues improved with treatment, but blindness persisted.

Abstract

Cerebral venous thrombosis (CVT) is caused by occlusion of dural sinuses and cerebral and cerebellar veins. It is a rare type of stroke usually presenting with headache, seizure, and focal motor deficit. We report a case of a 27-year-old Asian female with no significant medical history but a four-year history of unsupervised use of oral contraceptives, who presented with a sudden-onset headache followed by a generalized tonic-clonic seizure. Neurologic examination revealed papilledema with light perception in both eyes, right lateral rectus palsy, and bilateral sensorineural hearing loss. Imaging studies showed a subacute convexal subarachnoid hemorrhage over the right parietal lobe and thrombosis in the posterior superior sagittal sinus. She was given levetiracetam for seizure control and dabigatran for anticoagulation. Upon discharge, her hearing loss and lateral rectus palsy had resolved; however, bilateral blindness persisted.

This case highlights the importance of recognizing rare manifestations of cerebral venous thrombosis, such as bilateral blindness and sensorineural hearing loss. These symptoms can be overlooked due to the more common presentations of headache, seizure, and focal motor deficits.

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