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General Reference

Nejm 2005;352:1791

Pathophys and Cause

Pathophys:Venous infarction and cerebral HT, blocked CSF flow

Epidemiology

Children and young adults; 75% women

Signs and Symptoms

Sx:Headache (90%), unaffected by position; h/o head injury, ob delivery, bcp use, LP, otitis/mastoiditis

Si:Seizure (40%), abducens palsy, papilledema

Course

80% recover full or near full function

Lab and Xray

Xray:MRI, CT angiography

Treatment

Rx:Heparinize despite risk of bleeding into hemorrhagic infarcts, then warfarin × 6 mo to INR 2.5

of incr intracranial pressures: LPs and acetazolamide 500 mg po bid