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Cerebral venous thrombosis in a child with iron deficiency anemia and thrombocytosis
A L Belman1, C T Roque, R Ancona
1Department of Neurology, School of Medicine, State University of New York, Stony Brook 11794.
Insights
Iron deficiency anemia in a child can lead to serious neurological issues like seizures and stroke. Advanced imaging like MRI is crucial for diagnosing cerebral venous thrombosis and hemorrhagic infarcts.
Area of Science:
- Neurology
- Pediatrics
- Hematology
Background:
- Iron deficiency anemia and reactive thrombocytosis are common in children.
- Neurological complications can arise from these hematological conditions.
Observation:
- A 22-month-old boy presented with vomiting, headache, altered mental status, and seizures.
- Initial computed tomography (CT) revealed basal ganglia and thalamic infarction.
Findings:
- Magnetic resonance imaging (MRI) diagnosed cerebral venous thrombosis.
- MRI delineated vascular and parenchymal involvement, identifying hemorrhagic infarcts missed by CT due to low hemoglobin.
- MRI obviated the need for invasive angiography.
Implications:
- This case highlights the potential for severe neurological complications in pediatric iron deficiency anemia.
- MRI is essential for comprehensive diagnosis and management of cerebral venous thrombosis in anemic children.
- Non-invasive imaging can accurately characterize infarcts and guide treatment decisions.
Abstract:
We describe a 22-month-old boy with iron deficiency anemia and reactive thrombocytosis who developed vomiting, headache, mental status changes, and seizures. Computed tomography showed infarction of the basal ganglia and thalami. Magnetic resonance imaging revealed cerebral venous thrombosis, delineated the extent of the vascular and associated parenchymal involvement, showed the infarcts to be hemorrhagic (a finding not imaged by computed tomography due to our patient's depressed hemoglobin level), and obviated the need for invasive angiography.