Postoperative dural sinus thrombosis in a patient in a hypercoagulable state

2006 ◽  
Vol 105 (5) ◽  
pp. 772-774 ◽  
Author(s):  
Bradley C. Lega ◽  
Daniel Yoshor

✓ Spontaneous cerebral venous sinus thrombosis is a rare problem that may be encountered in patients with underlying thrombophilic disorders. It has also been reported as a postoperative complication following suboccipital, transpetrosal, and transcallosal approaches. The authors report on a 67-year-old man with two prior episodes of lower-extremity deep venous thrombosis who underwent transcallosal resection of a colloid cyst and in whom sagittal sinus thrombosis developed 2 weeks thereafter. Results of a subsequent hematological workup revealed both a factor V Leiden mutation and the presence of antiphospholipid antibodies, two thrombophilic risk factors that likely contributed to the development of delayed postoperative sinus thrombosis. Although the safety of low-molecular-weight heparin (LMWH) after craniotomy has not been established in a randomized, controlled study, there is sufficient evidence to justify its use for prophylactic anticoagulation therapy in patients at high risk for postoperative cerebral venous thrombosis. The authors propose using LMWH prophylaxis in patients with thrombophilic disorders who undergo neurosurgical procedures in proximity to dural sinuses in an effort to prevent catastrophic venous infarction.

2003 ◽  
Vol 127 (10) ◽  
pp. 1359-1361 ◽  
Author(s):  
Christina L. Stephan ◽  
Karen SantaCruz ◽  
Corrie May ◽  
Steve B. Wilkinson ◽  
Mark T. Cunningham

Abstract Inherited thrombophilia is a risk factor for dural sinus thrombosis (DST). To our knowledge, this is the first description with autopsy findings of a patient with DST associated with heterozygous factor V Leiden and a short activated partial thromboplastin time (aPTT). A 51-year-old woman presented with a 3-day history of headache, nausea, right-sided weakness, and focal motor seizure; she died 3 days after admission. At autopsy, a gross examination showed hemorrhage of bilateral parietal lobes and left primary motor cortex, uncal and tonsillar herniation, and pulmonary embolus of the right upper lobe. A microscopic examination of the brain showed an organizing thrombus in the superior sagittal sinus, diffuse cerebral edema, and extensive venous congestion. Laboratory studies showed heterozygous factor V Leiden by polymerase chain reaction and a very short aPTT of 17 seconds (reference range, 22–30 seconds). The combination of a heterozygous factor V Leiden mutation and a short aPTT may have contributed to the fatal DST in this patient.


2010 ◽  
Vol 125 (5) ◽  
pp. 471-472 ◽  
Author(s):  
H.J. Ng ◽  
E.S. Koay ◽  
A. Abdul Ghafar ◽  
L.C. Lim ◽  
L.H. Lee

2006 ◽  
Vol 21 (1) ◽  
pp. 24-27 ◽  
Author(s):  
A Mansilha ◽  
F Araújo ◽  
M Severo ◽  
S M Sampaio ◽  
T Toledo ◽  
...  

Objective: To evaluate the association between the Factor V Leiden (FV R506Q) and prothrombin gene (FII G20210A) mutations and deep venous thrombosis (DVT) in young people. Methods: Blood samples were drawn from 199 subjects: 100 healthy controls and 99 unselected patients, with an objectively documented first episode of DVT under 40 years old. DNA analysis was performed using the polymerase chain reaction. Results: The mean age in the patient cohort was 27 years (range 16–40) and 68 (68.7%) were women. Patient prevalences were 20.6% and 10.1% for FV R506Q and FII G20210A, respectively. In the control group, carrier frequencies were 2% and 5%, respectively. We found an increased overall relative risk of DVT with statistical significance for FV R506Q carriers (OR: 12.8; 95% CI: 2.9–56.7; P < 0.001), but not for FII G20210A mutation (OR: 2.1; 95% CI: 0.7–6.5; P = 0.19). Conclusions: Our results suggest a possible increase in DVT risk for the young G20210A allele carriers, which can be more expressed in the presence of a circumstantial risk factor. There is extremely strong evidence that the Factor V Leiden mutation is an important risk factor in the development of a first episode of DVT in young people.


2004 ◽  
Vol 4 (1) ◽  
pp. 76-78
Author(s):  
Rouzbeh Chegeni . ◽  
Bahram Kazemi . ◽  
Abbas Hajifathali . ◽  
Aliakbar Pourfatholl . ◽  
Ghasem Rastegar Lari . ◽  
...  

2009 ◽  
Vol 57 (1) ◽  
pp. 91
Author(s):  
M Thomas ◽  
B George ◽  
J Mammen ◽  
S Aaron ◽  
M Alexander

2013 ◽  
pp. 25-29
Author(s):  
A.M. Pizzini ◽  
M. Silingardi ◽  
I. Iori

CASE REPORT We describe a 31 year-old woman with headache and acute onset of seizures. Medical history and physical examination were unremarkable. She has been on therapy with oral contraceptives for many years for dysmenorrhea. A CT scan was negative, but MRI and MR-angiography showed left transverse sinus thrombosis. Screening for thrombophilia revealed hyperhomocysteinemia and Factor V Leiden heterozigousity. The patient received unfractionated heparin, followed by long-term anticoagulation with warfarin (INR 2-3). CONCLUSIONS Cerebral venous thrombosis is a rare cerebrovascular disorder, frequently in young adult (about 75% are women). The diagnosis might be difficult with consequent high long-term morbidity and mortality rate. New neuroimaging techniques (MRI and MR-angiography) and more effective treatment (anticoagulation and endovascular thrombolysis) have improved the prognosis and the natural history. The risk factors, the clinical presentation, the diagnostic evaluation and the management of cerebral venous thrombosis are reviewed.


2017 ◽  
Vol 37 (7) ◽  
pp. 963-964 ◽  
Author(s):  
Abass Awad-Elkareem ◽  
Salaheldein G. Elzaki ◽  
Hanan Khalid ◽  
Mual S. Abdallah ◽  
Ishag Adam

2002 ◽  
Vol 106 (4-5) ◽  
pp. 265-267 ◽  
Author(s):  
P Miljic ◽  
M Colovic ◽  
Lj Rakicevic ◽  
V Djordjevic ◽  
D Boskovic

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