Title: A Case of Cerebral Venous Sinus Thrombosis in a Patient with Sickle Cell Disease
Authors: Dr M Mallikarjuna Reddy, Dr B Vinu, Dr Rajasekaran Durai
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.166
Abstract
We report a 30 year old woman with sickle cell disease (SCD) who presented with a severe right side headache and neck pain of 1 week duration. Results of a peripheral smear showed sickle cells and sickling test was positive. Magnetic resonance venography showed dural venous sinus thrombosis involving right transverse and sigmoid sinuses with venous infarcts involving right temporal & occipital lobes. The patient was treated with low molecular weight heparin,mannitol and her symptoms and signs resolved.
Keywords: Sickle cell disease, Dural venous sinus thrombosis, Magnetic resonance venography, Low molecular weight heparin.
Key Message: Involvement of Transverse sinus and Sigmoid sinus without involvement of Sagittal sinus is rare.
References
- Masuhr F, Mehraein S, Einhäupl K: Cerebral venous and sinus thrombosis. J Neurol 2004;251:11–23.
- Cumurciuc R, Crassard I, Sarov M, Valade D, Bousser MG. Headache as the only neurological sign of cerebral venous thrombosis: a series of 17cases.J Neurol Neurosurg Psychiatry 2005;76:1084–7.
- Brown MD, Wick TM, Eckman JR: Activation of vascular endothelial cell adhesion molecule expression by sickle blood cells. Pediatr Pathol Mol Med 2001;20:47–72.
- Westerman MP, Green D, Gilman-Sachs A, Beaman K, Freels S, Boggio L, Allen S, Zuckerman L, Schlegel R, Williamson P: Antiphospholipid antibodies, proteins C and S, and coagulation changes in sickle cell disease. J Lab Clin Med 1999;134:352–362.
- Brucker AB, Vollert- Rogenhofer H, Wagner M, et al. Heparin treatment in acute cerebral sinus venous thrombosis: a retrospective clinical and MR analysis of 42 cases. Cerebrovasc Dis 1998;8(6):331–337.
- Levine SR, Twyman RE, Gilman S. The role of anticoagulation in cavernous sinus thrombosis. Neurology 1988;38(4):517–522.
- Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004;35(3):664–670.