Psychiatry and Clinical Psychopharmacology

A case of visual, tactile and olfactory hallucinations occurred as a long-term complications of cerebral sinus venous thrombosis

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S110-S110
Read: 1016 Published: 18 February 2021

Cerebral sinus venous thrombosis (CSVT) is a rare disease. CSVT is almost 0.5%-3% of all the types of stroke, and typically occurs in young-to-middle-aged females. In this case report, we present a male patient who has visual, tactile and olfactory hallucinations occurred as a long-term complications of CVST. A 19 years old, male patient was admitted to neurology outpatient clinics with the complaints of headache and blurred vision. In his neurological examination, bilateral papilledema was detected. CT venography showed thrombus in cerebral venous sinus, Anticoagulant therapy was started. 9 months after the onset of his symptoms; he had visual, tactile and olfactory hallucinations. He had seen spider or a big balloon figure in front of his face and had feelings like somebody punching him. He was always crying, his appetite was poor, and he was sleeping too much. He was feeling as if he smelled some kinds of unpleasant odors especially sour ones. In the psychiatric examination patient seemed age-appropriate. Self-care was normal. He had bilateral visual loss. His mood was depressed and he was reluctant to respond to questions. The şow of his speech was slow. The content of his thoughts was focused on pessimism and religiousness. The patient’s visual, tactile, and olfactory hallucinations were present. Physical examination was normal. On neurological examination, there were no abnormal findings except bilateral papilledema. He had no history of any psychiatric and organic diseases. He had no any trauma or history of substance use. In his family history his father had as the diagnosis of Obsessive compulsive disorder. The patient’s clinical features were diagnosed as psychotic disorder caused by an organic etiology. For psychotic symptoms olanzapine 5 mg / day and for depressive symptoms sertraline 50 mg / day were started. And antipsychotic level was gradually increased. The patient’s hallucinations and depressive symptoms were decreased in later stages with sertraline 50 mg / day and olanzapine 20 mg / day treatment. Patients were still in follow-up by psychiatry and neurology departments, and the latest medical treatment was consisting of warfarin, asetozalomid, olanzapine, sertraline and topiramate. Long-term complications of CVST are: recurrent sinus thrombosis, other thrombotic events (limb or pelvic venous thrombosis, pulmonary embolism, stroke, TIA, acute limb ischemia), seizures, severe headache and mild depression. However, there hasn’t been any case reported previously as our case presented with visual-tactile-olfactory hallucinations during CVST course. Therefore, it should be considered that hallucinations can occur as a long-term complication of CSVT.

EISSN 2475-0581