An ‘uncommon” headache at our doorsteps: Cerebral venous sinus thrombosis from combined haemoglobinopathy and protein S deficiency,presenting with papilledema [Kapımızda yaygın görülmeyen bir başağrısı: Papilla ödemi,hemoglobinopati ve protein S yetmezliği ile prezante olan serebral venöz tromboz]

Headache is a common and protean disorder. the causes of headache range from relatively benign conditions like migraine,to potentially life threatening causes like ruptured intracranial aneurysms. the diagnostic challenge of headache arises when it occurs in association with symptoms characteristic of a wide variety of conditions. cerebral venous sinus thrombosis (cvst) is a rare form of cerebral vascular accident,occurring in young adults and women of childbearing age. it presents with headache,signs of raised intracranial pressure and occasionally,focal neurological signs resulting from ischaemia,infarction or heamorrhage into the subarachnoid space. headache is the commonest presenting symptom and may occur alone,making diagnosis difficult. diagnosis and management of cvst is also made difficult by the numerous risk factors,varied presentation and the absence of an accepted protocol for treatment. if undiagnosed and untreated,cvst has a high morbidity and mortality rate. we report the case of a 22-year-old woman with haemoglobin (hb) ac and protein s deficiency,who had a delayed diagnosis of left transverse sinus thrombosis following a 2-week history of fever and headache,with papilledema on examination. our objective is to draw attention to the importance of excluding cerebral venous thrombosis in young african adults,presenting with headache and features of intracranial hypertension. cvst,being very uncommon in this environment,was low on the list of likely differential diagnoses in this patient. this report serves to sensitize the african medical practitioner,to develop a high index of suspicion for this important disorder. © 2015,ege university press. all rights reserved.