• Junxi Li, Shenjie Li, Junrong Zhang, Yuqi Wen, Ke Wang, Xingzhao Luan, Wei Xiang, Ligang Chen, and Jie Zhou.
• Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
• Medicine (Baltimore). 2023 Mar 10; 102 (10): e33218e33218.

RationaleCerebral venous sinus thrombosis (CVST) represents 0.5% to 1% of all strokes. CVST can cause headaches, epilepsy, and subarachnoid hemorrhage (SAH). CVST is easily misdiagnosed because of the variety and non-specificity of symptoms. Herein, we report a case of infectious thrombosis of the superior sagittal sinus with SAH.Patient ConcernsA 34-year-old man presented to our hospital with a 4-hour history of sudden and persistent headache and dizziness with tonic convulsions of the limbs. Computed tomography revealed SAH with edema. Enhanced magnetic resonance imaging showed an irregular filling defect in the superior sagittal sinus.DiagnosesThe final diagnosis was hemorrhagic superior sagittal sinus thrombosis and secondary epilepsy.InterventionsHe was treated with antibiotic, antiepileptic, fluids to rehydrate, and intravenous dehydration.OutcomesAfter treatment, the seizures did not recur and the symptoms were relieved. One month after the antibiotic treatment, the muscle strength of the patient's right extremity was restored to level 5, and there was no recurrence of his neurological symptoms.LessonsWe describe a case of infectious thrombosis of the superior sagittal sinus manifested as SAH, which is easily misdiagnosed, especially when patients present with an infection. Clinicians must therefore take care during the diagnosis and selection of the treatment strategy.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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