Case of Cerebral Venous Thrombosis with Unusual Venous Infarcts

We present a paradoxical case of immune thrombocytopenia (ITP) that presented with cerebral venous thrombosis. A 39-year-old female patient diagnosed with chronic ITP, who failed treatment on multiple-line agents, was started on eltrombopag (thrombopoietin receptor agonist), which she was not compliant to. The patient later developed extensive cerebral venous thrombosis, along with venous infarcts, and intracranial and subarachnoid hemorrhage. She was treated with intravenous immunoglobulins as well as steroid therapy and was simultaneously started on anticoagulation. The patient improved clinically and radiologically. This case is among few reported cases which signify that patients with ITP are inherently prone to thrombosis despite low platelet count and treating these patients can be a dilemma. Judicious use of anticoagulation and immunosuppressive therapy is recommended based on available evidence pending further recommendations and guidelines about treatment of thrombosis in ITP.

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Diagnostics of cerebral venous thrombosis associated with COVID-19 in young adults: clinical characteristics and imaging patterns

Diagnostic radiology and radiotherapy ◽

10.22328/2079-5343-2021-12-3-43-53 ◽

2021 ◽

Vol 12 (3) ◽

pp. 43-53

Author(s):

F. Z. Olimova ◽

Ye. G. Klocheva ◽

V. N. Semich ◽

V. V. Goldobin ◽

S. V. Lobzin ◽

...

Keyword(s):

Young Adults ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Clinical Laboratory ◽

Brain Mri ◽

Intravenous Contrast ◽

Cerebrovascular Complications ◽

Contrast Magnetic Resonance ◽

Venous Infarcts ◽

Initiation Of Therapy

Introduction. Cerebral venous thrombosis (CVT) is relatively rare, but leads to the development of cerebral venous infarction, intracranial hemorrhage, followed by severe disability and death. Due to the epidemiological situation caused by COVID-19, the incidence of CVT is increasing.Aims and objectives: to analyze clinical, laboratory instrumental and neuroimaging (multislice computed tomography (MSCT), MSCT — with intravenous contrast, magnetic resonance imaging of the brain (MRI) and MRI venography) data that confirmed the development of CVT in patients with COVID-19.Methods. Data of 5 young adults with cerebral venous thrombosis (CVT) associated with COVID-19 are presented.Results. Аmong 5 reported cases of COVID-19, two patients presented with venous infarcts (hemorrhagic and ischemic), 3 patients developed encephalopathy syndrome without acute cerebral infarction.Conclusion. Possibilities of modern imaging technologies permitted to timely diagnosis cerebral venous thrombosis associated with COVID-19, that can lead to immediate initiation of therapy and to prevent the development of cerebrovascular complications during the COVID-19 pandemic.

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La risonanza magnetica nello studio delle trombosi venose cerebrali

Rivista di Neuroradiologia ◽

10.1177/197140098900200204 ◽

1989 ◽

Vol 2 (2) ◽

pp. 125-134 ◽

Cited By ~ 1

Author(s):

C.F. Andreula ◽

R. Paladini ◽

A. Carella

Keyword(s):

Contrast Media ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Risonanza Magnetica ◽

Diagnostic Problem ◽

Hyperintense Signal ◽

Venous Infarcts ◽

Nello Studio ◽

T2 Weighted Images

Gli autori propongono la risonanza magnetica come esame di prima scelta nello studio delle trombosi venose cerebrali. La presenza di un segnale iperintenso nelle immagini pesate in T1 e T2, lungo il decorso delle vene cerebrali, conferma senza dubbio la diagnosi. Vengono discussi i problemi relativi all'effetto paradosso del flusso ematico cerebrale ed i protocolli d'indagine di questa patologia. The use of MR without any dependance on field strenght can solve the diagnostic problem of cerebral venous thrombosis, avoiding contrast media and/or vessel puncture. In fact the easy detection of hyperintense signal within venous structures, revealed in T1 weighted images and persistent in T2 weighted images, confirm the clinical hyphothesis of cerebral venous thrombosis, without any further examinations. The higher sensibility of MR will show venous infarcts and haemorragic soffusions, sometimes maldetected by CT.

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Cerebral venous thrombosis in ulcerative colitis

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.105629 ◽

2013 ◽

Vol 04 (01) ◽

pp. 84-86 ◽

Cited By ~ 1

Author(s):

Bindu Menon ◽

Rajeev Goyal ◽

Lalit Nihal ◽

Rajasekhar Reddy

Keyword(s):

Magnetic Resonance Imaging ◽

Ulcerative Colitis ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Clinical Suspicion ◽

Resonance Imaging ◽

Appropriate Treatment ◽

Chief Complaints ◽

Venous Infarcts ◽

Uncommon Condition

ABSTRACTUlcerative colitis has been reported to show hyper coagulation leading to peripheral and rarely central thrombosis. A 35‑year‑old female was admitted with chief complaints of increased frequency of bloody diarrhea, abdominal pain, and weight loss for 2 months. The patient was diagnosed to have ulcerative colitis after sigmoidoscopy and biopsy and she was started on treatment. Two days later, the patient developed headache and seizures. Magnetic resonance imaging of brain showed cerebral venous thrombosis with venous infarcts. A high index of clinical suspicion is needed to diagnose this uncommon condition so that appropriate treatment can be initiated.

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Bilateral Decompressive Craniectomy in Malignant Cerebral Venous Thrombosis

European Journal of Case Reports in Internal Medicine ◽

10.12890/2020_001560 ◽

2020 ◽

Author(s):

Eduardo Soriano-Navarro ◽

Vanessa Cano-Nigenda ◽

Fernanda Menéndez-Manjarrez ◽

Esmirna Farington-Terrero ◽

Juan José Méndez-Gallardo ◽

...

Keyword(s):

Venous Thrombosis ◽

Decompressive Craniectomy ◽

Cerebral Venous Thrombosis ◽

Cerebral Oedema ◽

Therapeutic Option ◽

Midline Shift ◽

Sagittal Sinus ◽

Life Saving ◽

Venous Infarcts

Introduction: Despite the extremely favourable prognosis of patients with cerebral venous thrombosis (CVT), death occurs in 10–15% of patients. In severe cases of malignant CVT with supratentorial haemorrhagic lesions, cerebral oedema and brain herniation, decompressive surgery may be the only life-saving treatment. Patient and methods: We present the case of a puerperal young woman with progressive headache, seizures and decreased alertness. Thrombosis of the entire superior sagittal sinus with bifrontal venous infarcts and midline shift was confirmed by magnetic resonance imaging with venography sequencing. Despite medical treatment with anticoagulation, progressive neurological deterioration was observed, so bilateral, frontal decompressive craniectomy was performed. Results: At the 6-month follow-up, we observed partial functional recovery with a modified Rankin score of 3. Discussion: Bilateral decompressive craniectomy may be a life-saving therapeutic option when medical therapy fails and there are clinical and radiological features of progression in both cerebral hemispheres.

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