Fatal cerebral venous thrombosis as the initial manifestation of the antiphospholipid syndrome

We describe a patient with cerebral venous thrombosis (CVT) who presented with thrombocytopenia and persistent headache. The etiology of her CVT was determined to be the antiphospholipid syndrome (APLS) based on a prolonged dilute Russell viper venom test and elevated anti-cardiolipin IgG antibody. CVT has rarely been reported as the initial manifestation of the APLS. Despite supportive measures and anticoagulation, the patient expired. Clinicians should consider the possibility of CVT when coagulation abnormalities consistent with APLS are combined with neurologic symptoms. Early detection and treatment are crucial for a favorable outcome.