Intracranial Hypotension Syndrome with Cortical Venous Thrombosis: Letter to the Article Entitled “A Rare Case”

摘要

I read with great interest the report by Jain et al., which smartly illustrated the clinical course of a rare patient diagnosed with intracranial hypotension (ICH) syndrome and concurrent cortical venous thrombosis (CVT) (1). I agree with the interesting aspect of this report and appreciate the authors for presenting such a detailed illustration of this patient. However, I would like comment on this article hoping to provide some new perspectives to the article, as well as the issue of concurrent ICH and CVT.First, an important point that may be discussed was that the patient had recovered only mildly following conservative treatments with intravenous fluids and steroids. However, anticoagulation treatment had yielded full improvement in the following course. In the literature, there is considerable evidence supporting the occurrence of CVT as a consequence of ICH (2,3,4,5); hence, treatment of solely ICH, as the inducer agent, was generally recommended (6). In a retrospective review by Schievink and Maya (2), ICH was indicated as a risk factor for CVT; however, there was no evidence for CVT preceeding ICH in any patient. Thus, this report may give substantial perspectives revealing the role of anticoagulation among the treatment regimens of concurrent ICH and CVT.