Behçet’s Disease Presenting as Cerebral Venous Thrombosis

Pratibha Prasad^1* and Prem Shanker Verma^2
*Correspondence: Pratibha Prasad, Department of Neurology, Dr. S.N. Medical College, Rajasthan University of Health Science, Jodhpur, Rajasthan, India, Email:

Clinical Image

Occurrence of Cerebral Venous Thrombosis (CVT) as a presenting symptom of Behcet’s Disease (BD) is quite uncommon [1]. Few cases regarding the first presentation of BD with CVT are reported [2-5] but hardly any case in Indian perspective. Therefore, we report cerebral venous thrombosis as the initial presentation of Behçet's disease in a 32-year-old immunocompetent Indian male. He presented with severe headache and vomiting with gradual progressive painless loss of vision in both eyes (right> left) since one and half month. Past history revealed recurrent oral and genital ulcers in last seven months. Neurological examination revealed bilateral papilledema and right sixth cranial nerve palsy. Ophthalmoscopy revealed panuveitis with papilloedema in right eye (Figure 1A) more than left eye (Figure 1B). MRV showed right transverse sinus and superior saggital sinus thrombosis (Figure 2). Thrombophilia screening showed positivity in HLAB51. Pathergy test was positive. A diagnosis of behcet disease was made. Patient was treated with anti-coagulant therapy, immunosuppressive drug and acetazolamide and was in follow up for one year with no recurrent symptoms. Thus there is a need to increase the awareness of neuro behcet’s disease whenever headache due to CVT is associated with oral and genital ulcers.

References

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