Three girls, ages 11, 14, and 17, with systemic lupus erythematosus, who had headache and were diagosed with cerebral vein thrombosis are reported from the Hospital for Sick Children, University of Toronto, and the Children’s Hospital, McMaster University, Hamilton, Canada. Diagnosis was established by CT and MRI without need of angiography. Cerebral infarct occurred in one patient when diagnosis was delayed. All patients received low-dose oral anticoagulation and treatment for lupus and none had further thrombotic events during 10-18 month follow-up. [1]

COMMENT. Headache is the chief presenting symptom of cerebral venous thrombosis. These are of the tension or vascular type in 25%, but migraine headache and those associated with increased intracranial pressure also occur. Associated seizures, papilledema, and hemiparesis are also suggestive. A severe, persistent, throbbing headache, unresponsive to analgesics, points to a possible cerebral vein thrombosis, and is an indication for CT examination.