Pseudotumor Cerebri Secondary to Jugular Bulb Thrombosis: A Case Report and a Review of the Diagnostic Steps

Pseudotumor cerebri (PTC) secondary to cerebral venous sinus thrombosis can be a difficult diagnosis to make for various reasons, including an atypical patient profile and potentially pleomorphic signs and symptoms. The symptoms can be insidious and can evolve acutely, subacutely, or chronically. To complicate the picture even further, neurodiagnostic testing can be particularly troublesome due to both false-positive and false-negative results. Frequently, multiple imaging modalities are variably deployed, and they include computed tomography (CT) with and without contrast, computed tomography venogram (CTV), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) of the brain. The thrombus can be quite subtle, requiring the seasoned eye of an experienced neuroradiologist. Nevertheless, when a diagnosis is made, the treatment can be highly efficacious and gratifying as it can prevent serious visual complications. We present a rare case of PTC due to a jugular bulb thrombosis and outline the challenging diagnostic steps.