HIV infection presenting as cerebral venous sinus thrombosis
Risk of cerebrovascular disease is increased in patients with HIV infection; however, cerebral venous sinus thrombosis is not commonly reported in this condition. We report a case of young man with intracranial hemorrhage whose radiologic investigations revealed thrombosis of the left transverse and...
Saved in:
| Published in | The American journal of emergency medicine Vol. 30; no. 3; pp. 517.e1 - 517.e3 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.03.2012
Elsevier Limited |
| Subjects | |
| Online Access | Get full text |
Cover
Loading…
| Abstract | Risk of cerebrovascular disease is increased in patients with HIV infection; however, cerebral venous sinus thrombosis is not commonly reported in this condition. We report a case of young man with intracranial hemorrhage whose radiologic investigations revealed thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. On further investigations, he was found to be positive for HIV-1, and his procoagulant workup showed protein S deficiency. He was started on anticoagulant therapy, after which he showed gradual recovery. This case highlights a rarely encountered presentation of HIV infection as cerebral venous sinus thrombosis. |
|---|---|
| AbstractList | Risk of cerebrovascular disease is increased in patients with HIV infection; however, cerebral venous sinus thrombosis is not commonly reported in this condition. We report a case of young man with intracranial hemorrhage whose radiologic investigations revealed thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. On further investigations, he was found to be positive for HIV-1, and his procoagulant workup showed protein S deficiency. He was started on anticoagulant therapy, after which he showed gradual recovery. This case highlights a rarely encountered presentation of HIV infection as cerebral venous sinus thrombosis. Several disorders can cause or predispose patients to CVT, including genetic and acquired prothrombotic disorders, hematologic disorders, vasculitis, pregnancy and puerperium, central nervous system infections, brain tumors, trauma, drugs like oral contraceptives, and other [1]; however, HIV infection as a predisposing factor has been reported in only a few patients [5]. Protein S is normally synthesized by endothelial cells, megakaryocytes, osteoblasts, hepatocytes, and other in the body. Because HIV has been found within endothelial cells of cerebral blood vessels [3], it has been suggested that protein S deficiency can result from abnormal endothelial cell function during HIV infection [8]. |
| Author | Singla, Veenu, MD Khandelwal, Niranjan, MD Sharma, Aman, MD Prabhakar, Sudesh, DM Ahluwalia, Jasmina, MD Duberkar, Dhananjay, DM Modi, Manish, DM |
| Author_xml | – sequence: 1 fullname: Modi, Manish, DM – sequence: 2 fullname: Singla, Veenu, MD – sequence: 3 fullname: Ahluwalia, Jasmina, MD – sequence: 4 fullname: Sharma, Aman, MD – sequence: 5 fullname: Prabhakar, Sudesh, DM – sequence: 6 fullname: Khandelwal, Niranjan, MD – sequence: 7 fullname: Duberkar, Dhananjay, DM |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21406317$$D View this record in MEDLINE/PubMed |
| BookMark | eNp9kcFq3DAQhkVJaDZpX6CHYuihJ29nJMuyIRRCaJtAIIekvQpZGrdybXkreQN5-8ps2kIOhUG6fDPMfP8pOwpzIMbeIGwRsP4wbM1A05YD4hZycf6CbVAKXjao8IhtQAlZ1kqqE3aa0gAZrGT1kp1wrKAWqDbs_Or6W-FDT3bxcyh2kRKFxYfvhUmFpUhdNGPxQGHepyL5kN_lR5ynbk4-vWLHvRkTvX76z9jXz5_uL6_Km9sv15cXN6WV0CylAkeq6ZtOGjDc1XUnsJVdj4okVK4jxLpH1xmsuBOqMc61RLKC1hkQfSPO2PvD3F2cf-0pLXryydI4mkB5L91yVbfYiiqT756Rw7yPIS-nEQS0VTYjMsUPlI1zSpF6vYt-MvExQ3pVqwe9qtWrWg25OM9Nb59G77uJ3N-WPy4zcH4AKKt48BR1sp6CJedj1qvd7P8__-Ozdjv64K0Zf9IjpX936MQ16Ls13DVbRADIoYvftiCfqw |
| CitedBy_id | crossref_primary_10_1016_j_dsx_2021_04_026 crossref_primary_10_1016_j_jns_2017_04_034 |
| Cites_doi | 10.1016/S1474-4422(07)70029-7 10.1182/blood.V84.2.483.483 10.1161/01.STR.0000043821.35051.FA 10.1007/BF01716703 10.1097/00002030-199003000-00010 10.1182/blood.V81.7.1801.1801 10.1016/j.revmed.2007.12.022 10.1056/NEJMra042354 |
| ContentType | Journal Article |
| Copyright | Elsevier Inc. 2012 Elsevier Inc. |
| Copyright_xml | – notice: Elsevier Inc. – notice: 2012 Elsevier Inc. |
| DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 3V. 7RV 7T5 7X7 7XB 88E 8FI 8FJ 8FK 8G5 ABUWG AFKRA AZQEC BENPR CCPQU DWQXO FYUFA GHDGH GNUQQ GUQSH H94 K9. KB0 M0S M1P M2O MBDVC NAPCQ PQEST PQQKQ PQUKI Q9U 7X8 |
| DOI | 10.1016/j.ajem.2011.01.022 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef ProQuest Central (Corporate) Nursing & Allied Health Database Immunology Abstracts Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) Research Library (Alumni Edition) ProQuest Central (Alumni) ProQuest Central ProQuest Central Essentials ProQuest Central ProQuest One Community College ProQuest Central Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Central Student Research Library Prep AIDS and Cancer Research Abstracts ProQuest Health & Medical Complete (Alumni) Nursing & Allied Health Database (Alumni Edition) Health & Medical Collection (Alumni Edition) PML(ProQuest Medical Library) Research Library Research Library (Corporate) Nursing & Allied Health Premium ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central Basic MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef Research Library Prep ProQuest Central Student ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College Research Library (Alumni Edition) ProQuest Central Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea AIDS and Cancer Research Abstracts ProQuest Research Library ProQuest Medical Library (Alumni) ProQuest Central Basic ProQuest One Academic Eastern Edition ProQuest Nursing & Allied Health Source ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Hospital Collection (Alumni) Nursing & Allied Health Premium ProQuest Health & Medical Complete ProQuest Medical Library ProQuest One Academic UKI Edition Immunology Abstracts ProQuest Nursing & Allied Health Source (Alumni) ProQuest One Academic ProQuest Central (Alumni) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic Research Library Prep |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database – sequence: 3 dbid: BENPR name: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1532-8171 |
| EndPage | 517.e3 |
| ExternalDocumentID | 2727706191 10_1016_j_ajem_2011_01_022 21406317 S0735675711000532 1_s2_0_S0735675711000532 |
| Genre | Journal Article Case Reports |
| GroupedDBID | --- --K --M .1- .FO .GJ .~1 0R~ 123 1B1 1P~ 1RT 1~. 1~5 23M 354 3V. 4.4 457 4G. 53G 5RE 5VS 6J9 7-5 71M 7RV 7X7 88E 8F7 8FI 8FJ 8G5 8P~ 9JM A8Z AACTN AAEDT AAEDW AAIKJ AAKOC AALRI AAOAW AAQFI AAQQT AAQXK AAWTL AAXKI AAXUO ABBQC ABFNM ABJNI ABLJU ABMAC ABMZM ABOCM ABUWG ABXDB ACDAQ ACGFO ACGFS ACIWK ACPRK ACRLP ADBBV ADEZE ADFRT ADMUD AEBSH AEKER AENEX AEVXI AFCTW AFFNX AFJKZ AFKRA AFKWA AFRAH AFRHN AFTJW AFXIZ AGHFR AGUBO AGYEJ AHHHB AHMBA AIEXJ AIKHN AITUG AJOXV AJRQY AJUYK AKRWK ALIPV ALMA_UNASSIGNED_HOLDINGS AMFUW AMRAJ ANZVX ASPBG AVWKF AXJTR AZFZN AZQEC BENPR BKEYQ BKOJK BLXMC BNPGV BPHCQ BVXVI C45 CAG CCPQU COF CS3 DWQXO EBS EFJIC EJD EMOBN EO8 EO9 EP2 EP3 ESTFP EX3 F5P FDB FEDTE FGOYB FIRID FNPLU FYGXN FYUFA G-2 G-Q GBLVA GNUQQ GUQSH HDV HMK HMO HVGLF HZ~ IHE J1W K-O KOM LX1 M1P M29 M2O M41 MO0 N4W N9A NAPCQ O-L O9- OAUVE OBH OB~ OHH OM0 OVD OZT P-8 P-9 P2P PC. PQQKQ PROAC PSQYO Q38 R2- RIG ROL RPZ SAE SDF SDG SDP SEL SES SEW SJN SPCBC SSH SSZ SV3 T5K TEORI UAP UHS UNMZH UV1 WOW WUQ Z5R ZGI ZY1 ~G- AAIAV ABLVK ABYKQ AJBFU EFLBG HMCUK LCYCR UKHRP CGR CUY CVF ECM EIF NPM AAYXX CITATION 7T5 7XB 8FK H94 K9. MBDVC PQEST PQUKI Q9U 7X8 |
| ID | FETCH-LOGICAL-c508t-70de78f8b5a0a2d66b3195bf17e504dbe116f1dba142d378add9ee5409da03f83 |
| IEDL.DBID | .~1 |
| ISSN | 0735-6757 |
| IngestDate | Fri Oct 25 22:00:06 EDT 2024 Fri Nov 08 05:58:51 EST 2024 Thu Sep 26 15:49:12 EDT 2024 Sat Sep 28 07:52:37 EDT 2024 Fri Feb 23 02:23:33 EST 2024 Tue Oct 15 22:56:15 EDT 2024 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 3 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c508t-70de78f8b5a0a2d66b3195bf17e504dbe116f1dba142d378add9ee5409da03f83 |
| Notes | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 |
| PMID | 21406317 |
| PQID | 1030948173 |
| PQPubID | 1216387 |
| ParticipantIDs | proquest_miscellaneous_927691934 proquest_journals_1030948173 crossref_primary_10_1016_j_ajem_2011_01_022 pubmed_primary_21406317 elsevier_sciencedirect_doi_10_1016_j_ajem_2011_01_022 elsevier_clinicalkeyesjournals_1_s2_0_S0735675711000532 |
| PublicationCentury | 2000 |
| PublicationDate | 2012-03-01 |
| PublicationDateYYYYMMDD | 2012-03-01 |
| PublicationDate_xml | – month: 03 year: 2012 text: 2012-03-01 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States – name: Philadelphia |
| PublicationTitle | The American journal of emergency medicine |
| PublicationTitleAlternate | Am J Emerg Med |
| PublicationYear | 2012 |
| Publisher | Elsevier Inc Elsevier Limited |
| Publisher_xml | – name: Elsevier Inc – name: Elsevier Limited |
| References | Mochan, Modi, Modi (bb0030) 2003; 34 Stam (bb0010) 2005; 352 Lafeuillade, Sorice, Griggi (bb0040) 1994; 22 Berger, Harris, Gregorios (bb0015) 1990; 4 Hooper, Phillips, Ribeiro (bb0045) 1994; 84 Boussser, Ferro (bb0005) 2007; 6 Pedraza, Rivora, Saballs, Capdevila (bb0025) 1997; 25 Stahl, Wideman, Spira (bb0035) 1993; 81 Konin, Adoh, Adoubi (bb0020) 2008; 29 Stahl (10.1016/j.ajem.2011.01.022_bb0035) 1993; 81 Stam (10.1016/j.ajem.2011.01.022_bb0010) 2005; 352 Lafeuillade (10.1016/j.ajem.2011.01.022_bb0040) 1994; 22 Pedraza (10.1016/j.ajem.2011.01.022_bb0025) 1997; 25 Mochan (10.1016/j.ajem.2011.01.022_bb0030) 2003; 34 Hooper (10.1016/j.ajem.2011.01.022_bb0045) 1994; 84 Boussser (10.1016/j.ajem.2011.01.022_bb0005) 2007; 6 Berger (10.1016/j.ajem.2011.01.022_bb0015) 1990; 4 Konin (10.1016/j.ajem.2011.01.022_bb0020) 2008; 29 |
| References_xml | – volume: 6 start-page: 162 year: 2007 end-page: 170 ident: bb0005 article-title: Cerebral venous thrombosis: an update publication-title: Lancet Neurol contributor: fullname: Ferro – volume: 81 start-page: 1801 year: 1993 end-page: 1807 ident: bb0035 article-title: Protein S deficiency in men with long term human immunodeficiency virus infection publication-title: Blood contributor: fullname: Spira – volume: 84 start-page: 483 year: 1994 end-page: 489 ident: bb0045 article-title: Tumor necrosis factor-alpha downregulates protein S secretion in human microvascular and umbilical vein endothelial cells but not in the HepG-2 hepatoma cell line publication-title: Blood contributor: fullname: Ribeiro – volume: 34 start-page: 10 year: 2003 end-page: 15 ident: bb0030 article-title: Stroke in black South African HIV-positive patients: a prospective analysis publication-title: Stroke contributor: fullname: Modi – volume: 4 start-page: 239 year: 1990 end-page: 244 ident: bb0015 article-title: Cerebrovascular disease in AIDS: a case control study publication-title: AIDS contributor: fullname: Gregorios – volume: 25 start-page: 247 year: 1997 end-page: 249 ident: bb0025 article-title: Thrombosis of the superior longitudinal sinus in patients of AIDS. A review of literature publication-title: Rev Neurol contributor: fullname: Capdevila – volume: 22 start-page: 201 year: 1994 end-page: 203 ident: bb0040 article-title: Role of autoimmunity in protein S deficiency during HIV-1 infection publication-title: Infection contributor: fullname: Griggi – volume: 352 start-page: 1791 year: 2005 end-page: 1798 ident: bb0010 article-title: Thrombosis of cerebral veins and sinuses publication-title: N Engl J Med contributor: fullname: Stam – volume: 29 start-page: 508 year: 2008 end-page: 511 ident: bb0020 article-title: Unusual venous thrombosis revealing a human immunodeficiency virus infection and a protein S deficiency. Two cases and literature review publication-title: Rev Med Interne contributor: fullname: Adoubi – volume: 6 start-page: 162 year: 2007 ident: 10.1016/j.ajem.2011.01.022_bb0005 article-title: Cerebral venous thrombosis: an update publication-title: Lancet Neurol doi: 10.1016/S1474-4422(07)70029-7 contributor: fullname: Boussser – volume: 84 start-page: 483 year: 1994 ident: 10.1016/j.ajem.2011.01.022_bb0045 article-title: Tumor necrosis factor-alpha downregulates protein S secretion in human microvascular and umbilical vein endothelial cells but not in the HepG-2 hepatoma cell line publication-title: Blood doi: 10.1182/blood.V84.2.483.483 contributor: fullname: Hooper – volume: 34 start-page: 10 year: 2003 ident: 10.1016/j.ajem.2011.01.022_bb0030 article-title: Stroke in black South African HIV-positive patients: a prospective analysis publication-title: Stroke doi: 10.1161/01.STR.0000043821.35051.FA contributor: fullname: Mochan – volume: 22 start-page: 201 year: 1994 ident: 10.1016/j.ajem.2011.01.022_bb0040 article-title: Role of autoimmunity in protein S deficiency during HIV-1 infection publication-title: Infection doi: 10.1007/BF01716703 contributor: fullname: Lafeuillade – volume: 4 start-page: 239 year: 1990 ident: 10.1016/j.ajem.2011.01.022_bb0015 article-title: Cerebrovascular disease in AIDS: a case control study publication-title: AIDS doi: 10.1097/00002030-199003000-00010 contributor: fullname: Berger – volume: 81 start-page: 1801 year: 1993 ident: 10.1016/j.ajem.2011.01.022_bb0035 article-title: Protein S deficiency in men with long term human immunodeficiency virus infection publication-title: Blood doi: 10.1182/blood.V81.7.1801.1801 contributor: fullname: Stahl – volume: 29 start-page: 508 issue: 6 year: 2008 ident: 10.1016/j.ajem.2011.01.022_bb0020 article-title: Unusual venous thrombosis revealing a human immunodeficiency virus infection and a protein S deficiency. Two cases and literature review publication-title: Rev Med Interne doi: 10.1016/j.revmed.2007.12.022 contributor: fullname: Konin – volume: 25 start-page: 247 issue: 138 year: 1997 ident: 10.1016/j.ajem.2011.01.022_bb0025 article-title: Thrombosis of the superior longitudinal sinus in patients of AIDS. A review of literature publication-title: Rev Neurol contributor: fullname: Pedraza – volume: 352 start-page: 1791 year: 2005 ident: 10.1016/j.ajem.2011.01.022_bb0010 article-title: Thrombosis of cerebral veins and sinuses publication-title: N Engl J Med doi: 10.1056/NEJMra042354 contributor: fullname: Stam |
| SSID | ssj0011454 |
| Score | 2.0172036 |
| Snippet | Risk of cerebrovascular disease is increased in patients with HIV infection; however, cerebral venous sinus thrombosis is not commonly reported in this... Several disorders can cause or predispose patients to CVT, including genetic and acquired prothrombotic disorders, hematologic disorders, vasculitis, pregnancy... |
| SourceID | proquest crossref pubmed elsevier |
| SourceType | Aggregation Database Index Database Publisher |
| StartPage | 517.e1 |
| SubjectTerms | Adult Anticoagulants Brain tumors Central nervous system Contraceptives Emergency Emergency medical care HIV HIV Infections - complications HIV Infections - diagnosis Human immunodeficiency virus Humans Male Medical imaging Protein S Deficiency - complications Protein S Deficiency - diagnosis Protein S Deficiency - virology Sinus Thrombosis, Intracranial - diagnosis Sinus Thrombosis, Intracranial - etiology Sinuses Thromboembolism |
| SummonAdditionalLinks | – databaseName: ProQuest Central dbid: BENPR link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3fT9swED6xVkJ7QcDYFuiQH3ibImwnjlMJCcHUqpsEQtuY-mbZiSOBRlpI4e_nrnHCE5WivET5dWffffbdfQdw4tBLEZF4LL2q4lTyNHaZ9TFxgVu0mSKrqN756jqb3aa_5moeNtyakFbZ2cS1oS4XBe2Rn1I7LGIW0cn58jGmrlEUXQ0tND7AUOJKgQ9geDm5vvndxxFEuu6DhuOYUuyVDmUzbYaXvfcPgcSTiDvle67pPei5dkHTXdgJ2JFdtMregy1f78P2VYiOf4Kz2c9_rMuuqtmyrSxC38Rswwr_RDHi_-xlzcrKmrsaz9Ql4cEtmrvmAG6nk78_ZnHojhAXCKpWseal13mVO2W5lWWWOZxNylVCe8XT0nmBchalsyKVZaJzNGRj7xGgjUvLkypPPsOgXtT-K7DUE827F0WCcISLIsdVjM0KbrWwXCkbwfdOMGbZkmCYLjvs3pAYDYnRcDykjEB3sjNdeScaJN-E2dEYYRppuPlDaiGtEG0ddaiIQPV3BgDQOnaD9n3jG0ediszbS_oBEwHrL-PkoYiIrT2K2oylzsYIYdMIvrSa7f-PxlOG4Opw87OP4CN-iGyz0kYwWD09-28IU1buOIzFV16t42g priority: 102 providerName: ProQuest |
| Title | HIV infection presenting as cerebral venous sinus thrombosis |
| URI | https://www.clinicalkey.es/playcontent/1-s2.0-S0735675711000532 https://dx.doi.org/10.1016/j.ajem.2011.01.022 https://www.ncbi.nlm.nih.gov/pubmed/21406317 https://www.proquest.com/docview/1030948173 https://search.proquest.com/docview/927691934 |
| Volume | 30 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3Na9swFH-UDsYuY92n27TosNtwI8mW5cAuXWlJFxpGv5abkGwZElo3xFmP-9v7ni2njNEdBkbCtozkJ-m9n3hfAJ8dSikKJB5Lr6o4lTyNXWZ9TLHALfJMkVXk73w-zcbX6feZmm3Bce8LQ2aVgfd3PL3l1uHJMFBzuJzPh5e4OBXCXU1Bzyi_AXmwo_jDNX34e2PmgXC_zYRGjWNqHRxnOhsvu_B3IYwnhe6Uzwmn58BnK4RO38DrgB7ZUTfAHdjy9Vt4eR704-_g6_jshvX2VTVbdr5FKJ2YbVjhV6QlvmUPbVxW1sxrLClPwp27b-bNe7g-Pbk6HschP0JcIKxax5qXXudV7pTlVpZZ5nA_KVcJ7RVPS-cFUlqUzopUlonOkZWNvEeINiotT6o8-QDb9X3tPwFLPQV696JIEJBwUeR4jrFZwa0WlitlI_jSE8YsuzAYprcPWxgioyEyGo6XlBHonnamd_BEluSbsD8aI0wjDTd_zWEEavPlH8vAIIf_Z4-DforMUyekPkpzoZMI2OY1bh_SidjaI6nNSOpshCA2jeBjN7Ob_5N49swQXu3-55j24BXeyc5gbQDb69Uvv48IZu0O2iWKpZ7pA3hxdDYZT6meXPycYP3tZPrj4hGHC_CK |
| link.rule.ids | 315,783,787,4509,12068,21400,24128,27936,27937,31731,31732,33756,33757,43322,43817,45597,45691,74079,74636 |
| linkProvider | Elsevier |
| linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1LT9wwEB7xkIBLxbOk0NYHbijCduI4K1VCFQItlOXCQ3uz7MSRQCW7kC2_vzOJE04gRblEec3YM589M98AHDn0UkQkHkuvqjiVPI1dZn1MXOAWbabIKqp3ntxk4_v0aqqmYcOtCWmVvU1sDXU5K2iP_ITaYRGziE5O5y8xdY2i6GpoobEMq8TDRR0M9HRYcCHUb7ug4SimBHulQ9FMl99ln_xzoPAk2k75kWP6CHi2DuhiE74E5Mh-d6regiVfb8PaJMTGd-DX-PKB9blVNZt3dUXomZhtWOFfKUL8l721nKyseazxTD0Snt2seWx24f7i_O5sHIfeCHGBkGoRa156nVe5U5ZbWWaZw7mkXCW0VzwtnRcoZVE6K1JZJjpHMzbyHuHZqLQ8qfJkD1bqWe33gaWeSN69KBIEI1wUOa5hbFZwq4XlStkIjnvBmHlHgWH63LAnQ2I0JEbD8ZAyAt3LzvTFnWiOfBPmRmOEaaTh5pbUQloh0jrqTxGBGu4M7r9z6wat-6dvPOxVZN5fMgyXCNhwGacOxUNs7VHUZiR1NkIAm0bwtdPs8H8S150ZQqtvnz_7J6yP7ybX5vry5s8BbOBHyS4_7RBWFq___HcELAv3ox2V_wFVReTz |
| linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3dS-QwEB88BbkX8ePu7PmVh3uTYpI2TRcEEXVZ9RTB89i3kLQpKNrds3v-_TfTpr0nhdKX0qadmcz8ppn8BuCHwyhFROKx9KqKU8nT2GXWx8QFbtFniqyi_c43t9nkIb2aqmmof2pCWWXvE1tHXc4K-kd-RO2wiFlEJ0dVKIu4Ox-fzP_E1EGKVlpDO41PsKIxSyEL19Mh-ULY33ZEQ4umYnulwwaartbLPvmXQOdJFJ7yvSD1Hghtg9F4HdYCimSnndo3YMnXm7B6E9bJt-B4cvmb9XVWNZt3e4wwSjHbsMK_0mrxM3tr-VlZ81jjmfolvLhZ89h8gYfxxa-zSRz6JMQFwqtFrHnpdV7lTlluZZllDueVcpXQXvG0dF6gxEXprEhlmegcXdrIe4Rqo9LypMqTr7Bcz2q_DSz1RPjuRZEgMOGiyDGfsVnBrRaWK2UjOOwFY-YdHYbp68SeDInRkBgNx0PKCHQvO9Nv9ETX5JswTxojTCMNN_ekFtIKEdhRr4oI1HBngAJdiDfo6T8ccbdXkfk_yGA6EbDhMk4jWhuxtUdRm5HU2QjBbBrBt06zw_dJzEEzhFnfP372AayiQZqfl7fXO_AZ30l2pWq7sLx4_ev3ELss3H5rlP8ARN3pMQ |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=HIV+infection+presenting+as+cerebral+venous+sinus+thrombosis&rft.jtitle=The+American+journal+of+emergency+medicine&rft.au=Modi%2C+Manish&rft.au=Singla%2C+Veenu&rft.au=Ahluwalia%2C+Jasmina&rft.au=Sharma%2C+Aman&rft.date=2012-03-01&rft.pub=Elsevier+Inc&rft.issn=0735-6757&rft.eissn=1532-8171&rft.volume=30&rft.issue=3&rft.spage=517.e1&rft.epage=517.e3&rft_id=info:doi/10.1016%2Fj.ajem.2011.01.022&rft.externalDocID=S0735675711000532 |
| thumbnail_m | http://utb.summon.serialssolutions.com/2.0.0/image/custom?url=https%3A%2F%2Fcdn.clinicalkey.com%2Fck-thumbnails%2F07356757%2FS0735675712X00032%2Fcov150h.gif |