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  • Title: Bilateral papilledema with retinal hemorrhages in association with cerebral venous sinus thrombosis and paroxysmal nocturnal hemoglobinuria.
    Author: Hauser D, Barzilai N, Zalish M, Oliver M, Pollack A.
    Journal: Am J Ophthalmol; 1996 Oct; 122(4):592-3. PubMed ID: 8862066.
    Abstract:
    PURPOSE: To report a patient with paroxysmal nocturnal hemoglobinuria who complained of transient obscurations of vision and exhibited bilateral papilledema with retinal hemorrhages. METHODS: Case report. Computed tomography did not demonstrate any abnormality but magnetic resonance imaging disclosed signs of cerebral venous sinus thrombosis. RESULTS: The patient was treated with subcutaneous low molecular weight heparin and intravenous corticosteroids. Symptoms improved within one week and ophthalmoscopic signs resolved within four months. CONCLUSION: Bilateral papilledema with extensive retinal hemorrhages may be a sign of cerebral venous sinus thrombosis, a reported devastating complication of paroxysmal nocturnal hemoglobinuria. Thus, any patient with suspected cerebral venous sinus thrombosis should undergo magnetic resonance imaging, even when results of computed tomography are normal.
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