{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T21:20:59Z","timestamp":1770412859529,"version":"3.49.0"},"reference-count":5,"publisher":"IMR Press","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Hosp Med"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:p>A 26-year-old African-American male with no significant past medical history first presented in 1994 to another hospital with sudden onset headache, right-sided weakness, and language expressive difficulties 3 days after mild and otherwise uneventful head trauma while playing football. Magnetic resonance imaging (MRI) of the head and neck demonstrated a large left middle cerebral artery territory infarct and a left internal carotid artery mass interpreted as a pseudoaneurysm suggestive of arterial dissection. Workup at that time included evaluation for protein C\/S, antithrombin III, antinuclear antibody, lupus anticoagulant, the factor V Leiden mutation and erythrocyte sedimentation rate levels, all of which were negative or within normal limits. A transoesophageal echocardiogram did not show a thrombus or a patent foramen ovale. Haemoglobin electrophoresis, however, showed that the patient was a carrier of the sickle cell trait (haemoglobin A1 = 61%, haemoglobin A2 = 3%, haemoglobin S = 36%). He was discharged from the hospital on an antiplatelet agent.<\/jats:p>\n                  <jats:p>He presented 10 years later to the authors' emergency room with 2 days of left frontal headache accompanied by nausea, vomiting and photophobia. Days before this headache there were no other precipitating factors such as illness, trauma or obvious dehydration. His general exam was unremarkable. Pertinent findings on neurological exam were non-fluent speech, mild right upper extremity distal weakness and brisk right-sided reflexes. All of these findings were unchanged from the prior stroke per previous medical records. An MRI of the brain done 2 days after symptom onset demonstrated the old left middle cerebral infarction without evidence of a new ischaemic or haemorrhagic lesion but with increased signal in the superior sagittal (Figure 1) and transverse sinuses. Computed tomography (CT) angiogram of the brain revealed enlargement and hyperdensity involving the superior sagittal, transverse and sigmoid sinuses consistent with widespread thrombosis. CT angiogram of the neck showed focal stenosis (about 40%) of the high cervical internal carotid artery, and a more proximal thrombosed pseudoaneurysm (Figure 2), all likely residual from his prior arterial dissection. New laboratory workup included the anticardiolipin antibody, beta-2-glycoprotein, factor VIII, activated protein C resistance, prothrombin 20210A mutation, homocysteine and alpha-1- antitrypsin, all of which were either negative or within normal limits. The patient was started on anticoagulation 3 days after symptom onset and within 1 week experienced complete resolution of his headache.<\/jats:p>","DOI":"10.12968\/hmed.2006.67.7.21625","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T09:41:35Z","timestamp":1400838095000},"page":"380-381","source":"Crossref","is-referenced-by-count":4,"title":["Arterial dissection and cerebral venous thrombosis in sickle cell trait"],"prefix":"10.31083","volume":"67","author":[{"given":"Doris","family":"Cardenas","sequence":"first","affiliation":[{"name":"Department of Neurology, UCLA Medical Center, UCLA School of Medicine, Los Angeles, CA 90095, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Ovbiagele","sequence":"additional","affiliation":[{"name":"Department of Neurology, UCLA Medical Center, UCLA School of Medicine, Los Angeles, CA 90095, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","reference":[{"key":"p_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.18.3.656"},{"key":"p_2","doi-asserted-by":"publisher","DOI":"10.1053\/hupa.2002.128059"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10192"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-60-3-465"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2281020600"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/hmed.2006.67.7.21625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:19:52Z","timestamp":1770373192000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/67\/7\/10.12968\/hmed.2006.67.7.21625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7]]},"references-count":5,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2006,7]]}},"alternative-id":["10.12968\/hmed.2006.67.7.21625"],"URL":"https:\/\/doi.org\/10.12968\/hmed.2006.67.7.21625","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7]]}}}