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JCR: Journal of Clinical Rheumatology:
doi: 10.1097/RHU.0b013e31827d8c5d
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Papilledema Caused by Cerebral Venous Sinus Thrombosis in a Patient With Behçet Disease

Aydin, Ali Ekrem MD*; Gunduz, Ozgul MD; Sari, Ismail MD; Saatci, Ali Osman MD; Yilmaz, Erkan MD§; Akkoc, Nurullah MD

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From the *Department of Internal Medicine, †Division of Rheumatology, Department of Internal Medicine, and Departments of ‡Ophthalmology and §Radiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey.

The authors report no conflict of interest.

Correspondence: Ismail Sari, MD, Dokuz Eylul Universitesi, Tip Fakultesi, Ic Hastaliklari ABD, Romatoloji BD, PK 35340, Balcova, Izmir, Turkey. E-mail: ismailsari35@gmail.com.

A 37-year-old man presented with acute-onset headache and blurred vision on both eyes. Ophthalmologic examination showed decreased visual acuity, retinitis in the right eye (Fig. A), and bilateral swelling of the optic nerve heads (Figs. A, B). Lumbar puncture revealed a high opening pressure; cranial magnetic resonance angiography (MRA) showed thrombosis in both sigmoid venous sinuses (Figs. E, F). A detailed medical history revealed that the patient had had arthritis on his hands and right knee 2 years ago. Over the past 3 years, the patient also noted recurrent oral aphthous ulcers and acneiform lesions on his back and arms. Behçet disease was diagnosed, and the patient was given oral corticosteroids (methylprednisolone 1 g daily was administered intravenously for 3 days, followed by oral prednisolone that was tapered from 60 mg daily and discontinued after 3 months) and azathioprine (3 mg/kg per day). Nine months after the initial presentation, active disease findings in both eyes disappeared (Figs. C, D), and phase contrast MRA showed normal blood flow in sigmoid venous sinuses (Fig. G).

FIGURE. A, Scattered...
FIGURE. A, Scattered...
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© 2013 Lippincott Williams & Wilkins, Inc.

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