Ann Rehabil Med.  2014 Oct;38(5):698-701. 10.5535/arm.2014.38.5.698.

Cerebral Venous Sinus Thrombosis and Venous Hemorrhagic Infarction in a Young Woman

• Choe Y
• Lee JB
• Kim YJ
• Choi IS

• KMID: 2266506
• DOI: http://doi.org/10.5535/arm.2014.38.5.698

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon cause of cerebral infarction, compared to arterial diseases. It is often unrecognized at initial presentation due to the diversity of causes and clinical manifestations. A 29-year-old female patient complained of severe headache and presented at the emergency room with altered consciousness. Brain computed tomography and brain magnetic resonance image revealed the left sigmoid sinus thrombosis with venous hemorrhagic infarction (VHI) in the left temporal lobe. The patient had no past medical and family history of bleeding diathesis. The laboratory finding at the admission showed severe iron-deficiency anemia (IDA), and protein C and S activities were decreased. After the neurosurgery, iron replacement, and neurorehabilitation, the patient had a good recovery. There has been no known recurrence. We report our therapeutic intervention on a very rare case of CVST and VHI, with IDA as a probable cause of cerebral thrombosis.

Keyword

Anemia; Iron-deficiency anemia; Intracranial thrombosis; Stroke

MeSH Terms

Adult
Anemia
Anemia, Iron-Deficiency
Brain
Cerebral Infarction
Colon, Sigmoid
Consciousness
Disease Susceptibility
Emergency Service, Hospital
Female
Headache
Hemorrhage
Humans
Infarction*
Intracranial Thrombosis
Iron
Neurosurgery
Protein C
Recurrence
Sinus Thrombosis, Intracranial*
Stroke
Temporal Lobe
Iron
Protein C

Figure

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  Fig. 1 Brain computed tomography shows high attenuated lesion (black arrow) in the left temporal lobe.

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  Fig. 2 Magnetic resonance images of brain. (A) T1-weighted axial image shows low signal intensity involving the left temporal lobe (black arrow). (B) T2-weighted axial image and (C) diffusion-weighted image show high signal intensity (black arrow) involving the left temporal lobe with gyral hemorrhage. (D) Post-gadolinium T1-weighted image displays filling defect (black arrow) in the left sigmoid sinus.

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