{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:48Z","timestamp":1786649808130,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Cerebral venous sinus thrombosis (CVST) is a rare type of stroke with a variable presentation. Without a prompt diagnosis, subacute presentation can delay treatment with devastating results. Our case presents an unusual clinical pattern of a young patient presenting with audio-visual hallucinations who was diagnosed with CVST. A 26-year-old man with no neurological or psychological history presented with audio-visual hallucinations, transient uncontrolled movements of his left upper extremities, and right-sided headache. Physical examination was nonfocal, and he demonstrated normal awareness, orientation, and motor function. CT angiography, CT venography (CTV) of the head, and magnetic resonance imaging of the brain were suggestive of multiple intracranial malformations versus neoplasm. The patient underwent digital subtraction angiography, which demonstrated nonocclusive thrombi in several right posterior temporal cortical veins. There was also a nonocclusive thrombus in the right sigmoid sinus. No intracranial aneurysm, arteriovenous malformation, or arteriovenous shunting was found. The patient was started on antiseizure medication as treatment for ongoing hallucinations and convulsions. After several days of intravenous heparin, the patient was transitioned to oral anticoagulant. CVST is a rare cerebrovascular disease, accounting for 0.5% of all strokes. Diagnosis is usually made in young adults with pre-existing hypercoagulable risk factors or positive family history. With symptoms such as those mentioned above, a high degree of suspicion is required to mitigate delay in diagnosis and therapy. Our case is the first documented case of a young patient with no relevant past medical history and risk factors developing hallucinations related CVST.<\/jats:p>","DOI":"10.4103\/ant.ant-d-24-00007","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T13:00:11Z","timestamp":1769691611000},"page":"47-52","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Unprovoked Cerebral Venous Infarction Presenting as Audio-Visual Hallucinations: A Case Presentation"],"prefix":"10.4103","volume":"35","author":[{"given":"Brendan","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Neurology, Northwell Health, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamzah","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwell Health, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Proteasa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwell Health, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Lado","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwell Health, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Franceschi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina Maria","family":"Youn","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwell Health, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1097\/PRA.0000000000000746","article-title":"The neuropsychiatric side of cerebral venous thrombosis: A case of delirium and catatonia","volume":"29","author":"Calva-Gonz\u00e1lez","year":"2023","journal-title":"J Psychiatr Pract"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11886-021-01622-z","article-title":"Updates in cerebral venous thrombosis","volume":"24","author":"Alimohammadi","year":"2022","journal-title":"Curr Cardiol Rep"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1161\/STR.0b013e31820a8364","article-title":"Diagnosis and management of cerebral venous thrombosis: A statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"42","author":"Saposnik","year":"2011","journal-title":"Stroke"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.thromres.2018.07.005","article-title":"Non-genetic and genetic risk factors for adult cerebral venous thrombosis","volume":"169","author":"Green","year":"2018","journal-title":"Thromb Res"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1161\/01.str.0000442009.06663.48","article-title":"Guidelines for the prevention of stroke in women: A statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"45","author":"Bushnell","year":"2014","journal-title":"Stroke"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1161\/01.STR.0000117571.76197.26","article-title":"Prognosis of cerebral vein and Dural sinus thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT)","volume":"35","author":"Ferro","year":"2004","journal-title":"Stroke"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"3130","DOI":"10.1161\/STROKEAHA.117.018829","article-title":"Safety of pregnancy after cerebral venous thrombosis: Results of the ISCVT (International Study on Cerebral Vein and Dural Sinus Thrombosis)-2 PREGNANCY study","volume":"48","author":"Aguiar de Sousa","year":"2017","journal-title":"Stroke"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1161\/STROKEAHA.118.023017","article-title":"Postpartum period is a risk factor for cerebral venous thrombosis","volume":"50","author":"Silvis","year":"2019","journal-title":"Stroke"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.radcr.2023.09.096","article-title":"Cerebral venous sinus thrombosis with hemorrhagic infarct: A rare presentation in a risk-defying male patient","volume":"19","author":"Katwal","year":"2024","journal-title":"Radiol Case Rep"},{"issue":"Suppl 1","key":"R10-20260420","doi-asserted-by":"crossref","first-page":"S238","DOI":"10.1111\/jth.12945","article-title":"Cerebral venous thrombosis","volume":"13","author":"Coutinho","year":"2015","journal-title":"J Thromb Haemost"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4103\/aian.aian_820_23","article-title":"Critical prognostic factors in cerebral venous sinus thrombosis: An observational study","volume":"27","author":"Gurram","year":"2024","journal-title":"Ann Indian Acad Neurol"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"274","DOI":"10.12659\/AJCR.913917","article-title":"Elevated factor VIII level associated with transverse cerebral venous sinus thrombosis","volume":"20","author":"Rawala","year":"2019","journal-title":"Am J Case Rep"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s11910-019-0932-0","article-title":"Neurologic complications of sickle cell disease","volume":"19","author":"Farooq","year":"2019","journal-title":"Curr Neurol Neurosci Rep"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1177\/09727531231183242","article-title":"Missed cerebral venous thrombosis: A diagnostic challenge","volume":"30","author":"Kashyap","year":"2023","journal-title":"Ann Neurosci"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s11886-014-0523-2","article-title":"Cerebral venous sinus thrombosis: Update on diagnosis and management","volume":"16","author":"Ferro","year":"2014","journal-title":"Curr Cardiol Rep"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1007\/s00234-022-02938-5","article-title":"A clinico-radiological study of deep cerebral venous thrombosis","volume":"64","author":"Kalita","year":"2022","journal-title":"Neuroradiology"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1148\/rg.2019190015","article-title":"Radiologic clues to cerebral venous thrombosis","volume":"39","author":"Canedo-Antelo","year":"2019","journal-title":"Radiographics"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.crad.2019.12.009","article-title":"Imaging of cerebral venous thrombosis","volume":"75","author":"Ghoneim","year":"2020","journal-title":"Clin Radiol"},{"key":"R19-20260420","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1038\/nrneurol.2013.192","article-title":"Cortical spreading depression and migraine","volume":"9","author":"Charles","year":"2013","journal-title":"Nat Rev Neurol"},{"key":"R20-20260420","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1212\/WNL.45.4.664","article-title":"Persistent positive visual phenomena in migraine","volume":"45","author":"Liu","year":"1995","journal-title":"Neurology"},{"key":"R21-20260420","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/j.1526-4610.1989.hed2902082.x","article-title":"Migraine-like visual phenomena associated with cerebral venous thrombosis","volume":"29","author":"Newman","year":"1989","journal-title":"Headache"},{"key":"R22-20260420","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.pjnns.2017.07.007","article-title":"Visual and somatosensory phenomena following cerebral venous infarction","volume":"51","author":"Loster-Niewi\u0144ska","year":"2017","journal-title":"Neurol Neurochir Pol"},{"key":"R23-20260420","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1186\/s13054-020-03131-x","article-title":"COVID-19-associated acute cerebral venous thrombosis: Clinical, CT, MRI and EEG features","volume":"24","author":"Roy-Gash","year":"2020","journal-title":"Crit Care"},{"key":"R24-20260420","first-page":"e22394","article-title":"Epilepsia partialis continua (EPC) as an uncommon initial presentation of Cerebral Venous Sinus Thrombosis (CVST)","volume":"14","author":"Chee","year":"2022","journal-title":"Cureus"},{"key":"R25-20260420","doi-asserted-by":"crossref","first-page":"220","DOI":"10.5853\/jos.2019.00150","article-title":"New oral anticoagulants versus warfarin for cerebral venous thrombosis: A multi-center, observational study","volume":"21","author":"Wasay","year":"2019","journal-title":"J Stroke"},{"key":"R26-20260420","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1001\/jamaneurol.2019.2764","article-title":"Safety and efficacy of dabigatran etexilate versus dose-adjusted warfarin in patients with cerebral venous thrombosis: A randomized clinical trial","volume":"76","author":"Ferro","year":"2019","journal-title":"JAMA Neurol"},{"key":"R27-20260420","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12883-021-02091-1","article-title":"Rivaroxaban for the treatment of cerebral venous thrombosis","volume":"21","author":"Esmaeili","year":"2021","journal-title":"BMC Neurol"},{"key":"R28-20260420","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/ane.13506","article-title":"Safety and efficacy of direct oral anticoagulants in cerebral venous thrombosis: A meta-analysis","volume":"145","author":"Nepal","year":"2022","journal-title":"Acta Neurol Scand"},{"key":"R29-20260420","first-page":"21m02927","article-title":"An observational study comparing the safety and efficacy of conventional anticoagulation versus new oral anticoagulants in the management of cerebral venous sinus thrombosis","volume":"23","author":"Shahid","year":"2021","journal-title":"prim care companion CNS Disord"},{"key":"R30-20260420","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1159\/000518524","article-title":"Extensive cerebral venous thrombosis secondary to recreational nitrous oxide abuse","volume":"51","author":"Farhat","year":"2022","journal-title":"Cerebrovasc Dis"},{"key":"R31-20260420","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s11239-019-02010-9","article-title":"Venous thrombosis after nitrous oxide abuse, a case report","volume":"49","author":"Pratt","year":"2020","journal-title":"J Thromb Thrombolysis"},{"key":"R32-20260420","doi-asserted-by":"crossref","first-page":"170","DOI":"10.7861\/clinmed.2022-0516","article-title":"Nitrous oxide misuse: A clue not to be missed in young patients with venous thromboembolism","volume":"23","author":"Er","year":"2023","journal-title":"Clin Med (Lond)"},{"key":"R33-20260420","first-page":"417","article-title":"A case of central venous sinus thrombosis after injection of zuclopenthixol","volume":"35","author":"Rillon","year":"2023","journal-title":"Psychiatr Danub"},{"key":"R34-20260420","doi-asserted-by":"crossref","first-page":"omac154","DOI":"10.1093\/omcr\/omac154","article-title":"Cerebral venous sinus thrombosis after COVID-19 vaccination: A case report and literature review","volume":"2023","author":"Elfil","year":"2023","journal-title":"Oxf Med Case Reports"},{"key":"R35-20260420","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1046\/j.1468-1331.2003.00513.x","article-title":"Cerebral venous thrombosis in four patients with multiple sclerosis","volume":"10","author":"Vandenberghe","year":"2003","journal-title":"Eur J Neurol"},{"key":"R36-20260420","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/WNN.0b013e318217b0cd","article-title":"Cerebral venous sinus thrombosis presenting with auditory hallucinations and illusions","volume":"24","author":"Wong","year":"2011","journal-title":"Cogn Behav Neurol"}],"container-title":["Acta Neurologica Taiwanica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ant.ANT-D-24-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:58:39Z","timestamp":1786647519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ant.ANT-D-24-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ant.ant-d-24-00007","relation":{},"ISSN":["1028-768X","3050-9173"],"issn-type":[{"value":"1028-768X","type":"print"},{"value":"3050-9173","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2024-07-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}