Severe Head Ache

[Mayil]

My Brother has "Complete thrombosis of right transverse and sigmoid dural venous sinus with externsion of thrombosis into the right jagular bulp and internal jagular vein". What should be done immediately..?

[Mayil]

Hi,

Thanks a lot for your effort and keep helping me.

My brother right now feel completely normal in health. No sleep issues. Everything he feel normal. With the report he consulted with another Neuro, to understand the root cause and how to prevent this in future. Doctor asked him to come back with the result of below tests. Looks like in india to get this test result it will take atleast 10 days it seems

Protein C and Protein S: Test
Antithrombin III Test
Factor V Leiden mutation
Aerin homocysteine
Anti-Phospholipid Antibodies

It would be great if you can suggest few important Do's and Dont's in his food habits and life style.

Is this life threatening disease..? He is just 37 and having 2 kids . both are less than 10.

[Dr Santos]

Hi,
Thanks for the update. Continue with the increased dosage of his medication as prescribed. The PT/INR is usually requested regularly with no set frequency to make sure that the prescription is working properly and that the PT/INR is appropriately prolonged.  However some substances such as alcohol, antibiotics, other medications and even food like beef and pork liver, green tea, broccoli, chickpeas, turnip greens, and soybean products contain large amounts of vitamin K and can alter PT results. How about any existing sleep disorder? Does your brother sleep well through out the night? This can be a factor in his sleepiness in the morning. Take care always.  

[Mayil]

Hi,

Today my brother met doctor with INR Report. Yesterday he felt little head ache...after had 1 hour of sleep he felt ok. INR is 1.45 and PT is 19.45. Now doctor increased acitrom 2mg to 3 mg. Advised to take another INR after 15 days before the next appointment.

[Mayil]

He is completely normal during day time. Only in the morning 6 to 8 he feel complete sleepiness. 3 weeks before he had some vision problem started very recently and now there is no mcuh vision issues. 80% vision issues recovered now after this treatment. Vision issues are not a complete blurness. He felt little power got increased very recently. As per the doctor, we have to have an appointment by 2-Mar-2011. We will try to have the approintment by 28-Feb-2011 itself with the INR Report.

[Dr Santos]

Hi,
How is your brother? Aside from being sleepy all the time, what other symptoms do you observe? Sleepiness is an uncommon side effect of acitrom and zovastin,according to literature. It is best that you inform his doctor about this prior to the said schedule of consultation. Take care and regards.

[Mayil]

After the CT scan only doctor said "Complete thrombosis of right transverse and sigmoid dural venous sinus with externsion of thrombosis into the right jagular bulp and internal jagular vein". After that 7 days he gave Thrombiflow 6mg - blood thinner for 5 days then 4 mg for 3 days. Now he started acitrom 2 mg. He advised to continue to same for another7 days and suggessted to come back with INR blood report. But after continueingthe below tablets, he feel soo sleepy in the morning. He has to continue the tablets for another 4 mre days.

acitrom 2 mg - Blood thinner
encorate to prevent from stoke
gutsaue vairu to avoid stomach fire.
zovastin to control colestrol level.

Can we continue the tablets for 4 more days or can we meet the doctor now itself with INR Report. He also advised him to start walking daily. But due to sleepy, he couldn't start.

At this moment MRI is required. Becasue we have already completed 7 days of course of Thrombiflow as injection and now he is taking acitrom 2 mg as a tablet. Please suggest.

[Dr Santos]

Hi,
Thanks for the update. What was the result of the CT scan? Diagnosis and the seriousness of the condition will be based on the findings of the tests done especially the CT scan. With regards to his blood test, the triglyceride and HDL are within normal values while LDL is only slightly elevated. However, normal test results differ from one laboratory to another and it is best that you discuss the results with his attending physician. Continue the medications as prescribed and regular follow-up is highly recommended. Take care and regards.

[Mayil]

Thanks a lot for your response. He met Nero docot and they gave Thrombiflow and other few medicine to prevent stroke. Blood test also taken and report say LDL as 156 and HDL as 36. They gave Zovastin for colestrol control. They did CT scan. As per their advice medicine has to be taken for few more week. How much serious is. He is just 37 years old. He has tricliciroid as 91. Looking for detailed response. Pleaase

[Dr Santos]

Hi,
How are you? Cerebral venous thrombosis often presents with hemorrhagic infarction and needs further evaluation by a neurologist. It is best that your brother sees his attending physician or be referred to a neurologist for proper  manageemnt. . Magnetic resonance venography (MRV) in conjunction with conventional MRI may also be done. Take care and do keep us posted.