Spontaneous Occlusion of Several Cerebral Venous Sinuses Mimicking Parkinson Disease

Abstract

Idiopathic occlusion of nearly all cerebral venous sinuses in association with the widespread formation of dural arteriovenous fistulas (AVF) is an extremely rare condition. The cause-and-effect relationship between thrombosis and AVF is not known, but a disturbance in venous flow and distant stagnation has been mentioned as probable pathomechanisms. We introduce a patient that was misdiagnosed as Parkinson's disease and treated accordingly for weeks. Then, rapidly-progressive dementia and shortly after that, an intracerebral hemorrhage occurred, and the diagnosis was established after Magnetic Resonance Imaging and Angiography. There were a whole venous sinus system thrombosis and the formation of numerous dural arteriovenous fistulas. The mechanism and diagnostic nuances are described in this paper, and the treatment options and prognosis are discussed.