When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis

ABSTRACT Cerebrovascular thrombosis is among the most critical medical conditions, making early diagnosis and management crucial. Although some symptoms of cerebrovascular thrombosis are typical and lead to early diagnosis, they can sometimes present with rare and unusual symptoms, complicating the...

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Main Authors: Tina Moghadam Fard, Mehrnaz Hosseinzadeh, MohammadAli Shokri, Mostafa Almasi‐Dooghaee, Fatemeh Sadat Mirfazeli
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.70038
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author Tina Moghadam Fard
Mehrnaz Hosseinzadeh
MohammadAli Shokri
Mostafa Almasi‐Dooghaee
Fatemeh Sadat Mirfazeli
author_facet Tina Moghadam Fard
Mehrnaz Hosseinzadeh
MohammadAli Shokri
Mostafa Almasi‐Dooghaee
Fatemeh Sadat Mirfazeli
author_sort Tina Moghadam Fard
collection DOAJ
description ABSTRACT Cerebrovascular thrombosis is among the most critical medical conditions, making early diagnosis and management crucial. Although some symptoms of cerebrovascular thrombosis are typical and lead to early diagnosis, they can sometimes present with rare and unusual symptoms, complicating the diagnostic process. Given the morbidity and mortality associated with these events, it is important to be aware of unexpected symptoms to diagnose and manage these patients more accurately and rapidly. We report a 74‐year‐old female initially misdiagnosed with Alzheimer's because of cognitive decline and disorganized speech. Her symptoms did not improve with Alzheimer's treatment. She was reevaluated by a neurologist, and her cognitive test results were impaired. Her brain MRI revealed a previously undetected left transverse sinus cerebral venous thrombosis with subcortical white matter lesions. The patient was managed acutely with subcutaneous enoxaparin and transitioned to oral rivaroxaban, resulting in significant improvement. This case report aimed to draw attention to the pitfalls of diagnosing dementia‐like syndromes in the elderly, advocating for a systematic approach to differential diagnosis. It emphasizes that a collaborative effort between psychiatrists, neurologists, radiologists, and other healthcare members is essential for accurate diagnosis and timely intervention, which can significantly alter the management and outcome for the patient.
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spelling doaj-art-1335371711ab46bba050c10263d1865e2025-01-24T05:08:46ZengWileyClinical Case Reports2050-09042025-01-01131n/an/a10.1002/ccr3.70038When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous ThrombosisTina Moghadam Fard0Mehrnaz Hosseinzadeh1MohammadAli Shokri2Mostafa Almasi‐Dooghaee3Fatemeh Sadat Mirfazeli4Cellular and Molecular Research Center, Faculty of Advanced Technologies in Medicine Iran University of Medical Sciences Tehran IranNational Brain Centre Iran University of Medical Sciences Tehran IranNational Brain Centre Iran University of Medical Sciences Tehran IranNational Brain Centre Iran University of Medical Sciences Tehran IranNational Brain Centre Iran University of Medical Sciences Tehran IranABSTRACT Cerebrovascular thrombosis is among the most critical medical conditions, making early diagnosis and management crucial. Although some symptoms of cerebrovascular thrombosis are typical and lead to early diagnosis, they can sometimes present with rare and unusual symptoms, complicating the diagnostic process. Given the morbidity and mortality associated with these events, it is important to be aware of unexpected symptoms to diagnose and manage these patients more accurately and rapidly. We report a 74‐year‐old female initially misdiagnosed with Alzheimer's because of cognitive decline and disorganized speech. Her symptoms did not improve with Alzheimer's treatment. She was reevaluated by a neurologist, and her cognitive test results were impaired. Her brain MRI revealed a previously undetected left transverse sinus cerebral venous thrombosis with subcortical white matter lesions. The patient was managed acutely with subcutaneous enoxaparin and transitioned to oral rivaroxaban, resulting in significant improvement. This case report aimed to draw attention to the pitfalls of diagnosing dementia‐like syndromes in the elderly, advocating for a systematic approach to differential diagnosis. It emphasizes that a collaborative effort between psychiatrists, neurologists, radiologists, and other healthcare members is essential for accurate diagnosis and timely intervention, which can significantly alter the management and outcome for the patient.https://doi.org/10.1002/ccr3.70038cerebral venous thrombosiscerebrovascular accidentdementiavascular dementiaWernicke aphasia
spellingShingle Tina Moghadam Fard
Mehrnaz Hosseinzadeh
MohammadAli Shokri
Mostafa Almasi‐Dooghaee
Fatemeh Sadat Mirfazeli
When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis
Clinical Case Reports
cerebral venous thrombosis
cerebrovascular accident
dementia
vascular dementia
Wernicke aphasia
title When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis
title_full When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis
title_fullStr When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis
title_full_unstemmed When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis
title_short When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis
title_sort when stroke disguises as dementia a case of missed cerebral venous thrombosis
topic cerebral venous thrombosis
cerebrovascular accident
dementia
vascular dementia
Wernicke aphasia
url https://doi.org/10.1002/ccr3.70038
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