BEHCETS-DISEASE - PRESENTATION WITH SAGITTAL SINUS THROMBOSIS DIAGNOSED NONINVASIVELY

The standard evaluation of patients with intracranial hypertension fre quently does not reveal a discrete pathophysiologic process, leading i n these cases to classification of the syndrome as ''benign.'' We pres ent a 35-year-old woman with a recent diagnosis of pseudotumor cerebri who presented with headache, emesis, and blurring of vision. Her symp toms were progressive despite two lumbar punctures that revealed norma l cerebrospinal fluid under high pressure. Contrast and noncontrast CT scans were normal; both the cerebrospinal fluid and CT neuroimaging w ere thus consistent with benign intracranial hypertension. An MRI, how ever, supported the presence of sagittal sinus thrombosis, a finding w hich was confirmed by MR venography. Further workup for an underlying cause of sinus thrombosis disclosed symptoms and signs fulfilling the diagnostic criteria for Behcet's disease. Cerebral venous (or sinus) t hrombosis should be considered in the differential diagnosis of intrac ranial hypertension. Behcet's disease, while extremely rare, should be considered as a potential cause of cerebral venous thrombosis. Magnet ic resonance venography can serve as a useful diagnostic study in situ ations where confirmation or exclusion of sinus thrombosis is required .