Diplopia and papilledema secondary to thrombosis of the longitudinal venous sinus due to Leiden factor V thrombophilia in a young patient.

We describe the ophthalmic findings in a case of cerebral venous thrombosis in a young patient. Observations: A five-year-old female presents with acute onset irritability, somnolence, diplopia, and headache. Ophthalmic exam showed normal vision, large esotropia with a VI nerve palsy and papilledema. MRI demonstrated longitudinal sinus thrombosis associated with Leiden factor V thrombophilia and an asymptomatic pulmonary thrombosis. Anticoagulant therapy was initiated resolving the diplopia and the disc edema, although MRI evidence of the sinus thrombosis persisted. Venous sinus thrombosis should be included in the differential diagnosis of cranial hypertension.