Response to Letter Regarding Article, “Cryptic Loss of Consciousness in a 36-Year-Old Woman”
We are pleased to observe that our Illustrative Teaching Case regarding loss of consciousness in a 36-year-old woman1 has raised interest. In the article, we presented several conditions that should be considered in the differential diagnosis of decreased consciousness and bilateral thalamic infarcts. As mentioned by Rebello and colleagues in their letter, one should also include in these conditions cerebral venous thrombosis leading to deep venous infarcts. We agree that this is especially true in our case with a young woman using oral contraceptive containing estrogen. Although cerebral venous thrombosis causing infarcts is more rarely presented, the diagnosis has a direct influence on optimal treatment, resulting in prescribing anticoagulation instead of antiplatelet medication.
Nicolas Martinez-Majander, MD
Jukka Putaala, MD, PhD, MSc (Stroke Med)
Department of Neurology
Helsinki University Hospital and University of Helsinki
Dr Putaala received funding from The Finnish Medical Foundation and Helsinki University Central Hospital for related research (significant). The other author reports no conflicts.
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