--- a
+++ b/data/text/es-S0365-66912008001000010-1.txt
@@ -0,0 +1,11 @@
+A 35-year-old male patient came to the emergency department with a severe bifrontoparietal headache lasting 8 hours, which did not change with Valsalva manoeuvres or posture, and partially subsided with analgesics.
+The patient's personal history included an episode of ICH treated with oral acetazolamide and naproxen, with clinical recovery and disappearance of papilledema.
+The general and neurological examination was normal, with a body mass index of 22 kg/m2. Ophthalmological examination showed a corrected visual acuity of 0.7 in both eyes. Intrinsic ocular motility, anterior segment examination and intraocular pressure (IOP) were normal.
+Funduscopic examination showed bilateral papilledema. Fluorescein angiography showed early bilateral peripapillary leakage. Nerve fibre layer study (fast RNFL strategy) by optical coherence tomography (Stratus OCT; Carl Zeiss Meditec, Dublin, CA) showed thickening of the fibre layer in the right eye (OD) and thickness at high limits of normal in the left eye (OI).
+Orbital ultrasound, computerised axial tomography and automatic perimetry were normal.
+Lumbar puncture was performed, showing an opening pressure of 30 cm of water, with normal CSF composition and serology.
+The analytical and coagulation studies and the determination of ANCAs, ANAs, PCR, RF, ASLO, thyroid hormones and antithyroid antibodies were negative.
+Magnetic resonance imaging (MRI) and phleboresonance imaging ruled out the presence of cranial sinus thrombosis, finding a segmental stenosis of the right lateral sinus.
+The patient was treated with acetazolamide and naproxen and clinical improvement was observed. After venography and cranial sinus manometry, a long stenosis of the right transverse sinus was observed with a pressure gradient of 7 mmHg, of a small amount and similar to that of the contralateral sinus. For this reason, and in view of the clinical improvement, dilatation by angioplasty and stenting was discarded.
+
+