{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:04Z","timestamp":1756377604972,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,16]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Cerebral venous sinus thrombosis is an uncommon sequela of low intracranial pressure, which may result from a lumbar puncture (LP). We describe a case of a patient in their 40s presenting with 48 hours of persistent headache following intrathecal administration of nusinersen for spinal muscular atrophy (SMA) type 3. There were no focal neurological signs or symptoms apart from baseline symmetrical proximal limb weakness attributed to SMA. Initial investigations revealed radiological evidence of an acute cerebral venous sinus thrombus (CVST). The patient was promptly started on anticoagulation. Partial recanalisation was seen as soon as 48 hours after commencement of anticoagulation, with almost full resolution of the thrombus at follow-up in 2 months. Awareness of CVST as a potential complication of intrathecal therapies and diagnostic LP allows for early identification, management and prevention of serious neurological consequences.<\/jats:p>","DOI":"10.1136\/bcr-2024-260080","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T22:50:15Z","timestamp":1736031015000},"page":"e260080","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cerebral venous sinus thrombosis after intrathecal administration of nusinersen"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-644X","authenticated-orcid":false,"given":"Aicee Dawn","family":"Calma","sequence":"first","affiliation":[{"name":"Neurosciences, Concord Repatriation General Hospital, Concord West, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Tan","sequence":"additional","affiliation":[{"name":"Radiology, Concord Repatriation General Hospital, Concord West, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Tohidi-Esfahani","sequence":"additional","affiliation":[{"name":"Haematology, Concord Repatriation General Hospital, Concord West, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Sanders","sequence":"additional","affiliation":[{"name":"Neurology and Neurosciences, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia"},{"name":"The University of Melbourne St Vincent's Department of Medicine, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kishore","family":"Kumar","sequence":"additional","affiliation":[{"name":"Neurosciences, Concord Repatriation General Hospital, Concord West, New South Wales, Australia"},{"name":"The University of Sydney Concord Clinical School, Concord West, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina","family":"Morris","sequence":"additional","affiliation":[{"name":"Neurosciences, Concord Repatriation General Hospital, Concord West, New South Wales, Australia"},{"name":"The University of Sydney Concord Clinical School, Concord West, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"2025082803012121000_18.1.e260080.1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg231"},{"key":"2025082803012121000_18.1.e260080.2","doi-asserted-by":"crossref","first-page":"3563","DOI":"10.1007\/s10072-020-04757-z","article-title":"Postdural puncture headache as a complication of lumbar puncture: clinical manifestations, pathophysiology, and treatment","volume":"41","author":"Ljubisavljevic","year":"2020","journal-title":"Neurol Sci"},{"key":"2025082803012121000_18.1.e260080.3","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1212\/CON.0000000000000979","article-title":"Spontaneous Intracranial Hypotension","volume":"27","author":"Wang","year":"2021","journal-title":"Continuum (Mount Lawley)"},{"key":"2025082803012121000_18.1.e260080.4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1212\/WNL.0000000000201111","article-title":"Pearls & Oy-sters: Postdural Puncture Headache, Cerebral Sinus Venous Thrombosis, and Reversible Cerebral Vasoconstriction Syndrome in the Peripartum Period","volume":"99","author":"Caranzano","year":"2022","journal-title":"Neurology (ECronicon)"},{"key":"2025082803012121000_18.1.e260080.5","doi-asserted-by":"crossref","unstructured":"Garg A , Rajendram P , Muccilli A , et al . Dural venous sinus thrombosis after lumbar puncture in a patient with idiopathic intracranial hypertension. Eur J Ophthalmol 2020. doi:10.1177\/1120672120970406","DOI":"10.1177\/1120672120970406"},{"key":"2025082803012121000_18.1.e260080.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmjno-2020-000046","article-title":"Cerebral venous thrombosis as a complication of intracranial hypotension after lumbar puncture","volume":"2","author":"Edwards","year":"2020","journal-title":"BMJ Neurol Open"},{"key":"2025082803012121000_18.1.e260080.7","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s13760-014-0305-z","article-title":"Dural puncture: an overlooked cause of cerebral venous thrombosis","volume":"115","author":"Guner","year":"2015","journal-title":"Acta Neurol Belg"},{"key":"2025082803012121000_18.1.e260080.8","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.3-41.v1","article-title":"Cerebral venous thrombosis in post-lumbar puncture intracranial hypotension: case report and review of literature","volume":"3","author":"Kate","year":"2014","journal-title":"F1000Res"},{"key":"2025082803012121000_18.1.e260080.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2004.10.014"},{"key":"2025082803012121000_18.1.e260080.10","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199702000-00024"},{"key":"2025082803012121000_18.1.e260080.11","first-page":"513","article-title":"Cerebral vein thrombosis after an intrathecal glucocorticoid injection","volume":"64","author":"Ergan","year":"1997","journal-title":"Rev Rhum Engl Ed"},{"key":"2025082803012121000_18.1.e260080.12","doi-asserted-by":"publisher","DOI":"10.1007\/BF00626091"},{"key":"2025082803012121000_18.1.e260080.13","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198909000-00050"},{"key":"2025082803012121000_18.1.e260080.14","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2019-002415"},{"key":"2025082803012121000_18.1.e260080.15","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13381"},{"key":"2025082803012121000_18.1.e260080.16","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000456"},{"key":"2025082803012121000_18.1.e260080.17","doi-asserted-by":"publisher","DOI":"10.1159\/000081912"},{"key":"2025082803012121000_18.1.e260080.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2008.01251.x"},{"key":"2025082803012121000_18.1.e260080.19","doi-asserted-by":"crossref","unstructured":"Wurster CD , Ludolph AC . Nusinersen for spinal muscular atrophy. Ther Adv Neurol Disord 2018;11. doi:10.1177\/1756285618754459","DOI":"10.1177\/1756285618754459"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:01:29Z","timestamp":1756375289000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,4]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-260080"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260080","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}