Beyond Aneurysms, Subarachnoid Hemorrhage Unraveling Dural Venous Sinus Thrombosis: A Rare Case Report

Background Dural venous sinus thrombosis (DVST) can be challenging for clinicians, especially when presenting with subarachnoid hemorrhage (SAH)-like symptoms. DVST presents with headache, vision loss, paralysis and seizures. Case presentation: We report a case of a 22-year-old male with left-sided weakness, severe headache and loss of consciousness. Examination revealed left-sided weakness and optic disc blurring. Lumbar puncture showed numerous RBCs. MRI brain with Magnetic Resonance Venography (MRV) revealed “left transverse and sigmoid venous sinus thrombosis and minimal subarachnoid hemorrhage.” A diagnosis of SAH secondary to DVST was made. The patient was treated with Apixaban, resulting in resolution of DVST and SAH. Conclusion This case highlights the need for early recognition of DVST in SAH patients lacking aneurysmal components or basal cistern involvement and its management with anticoagulation if hemodynamically stable.