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Unilateral Postoperative Deep Cerebral Venous Thrombosis with Complete Recovery: A Report of 2 Cases

Mony Benifla1, Suzzanne Laughlin, Zulma S Tovar-Spinoza

  • 1Divisions of Neurosurgery, Neuroradiology, and Neurooncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Pediatric Neurosurgery
|March 22, 2017
PubMed

Insights

Deep brain venous thrombosis is a rare postsurgical complication in children. Careful surgical technique and awareness are key for prompt diagnosis and management of internal cerebral vein thrombosis.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Vascular Neurology

Background:

  • Deep brain venous thrombosis is an underreported complication in pediatric neurosurgery.
  • Injury to deep cerebral veins during surgery for thalamic or intraventricular lesions can lead to thrombosis.
  • Postoperative hemodynamic changes or surgical manipulation can precipitate venous thrombosis.

Observation:

  • Two pediatric cases of unilateral postoperative internal cerebral vein (ICV) thrombosis are presented.
  • In one case, the vein of Galen was also involved.
  • Both patients presented with altered sensorium but recovered without anticoagulation.

Findings:

  • Postsurgical deep brain venous thrombosis, specifically involving the internal cerebral veins (ICVs) and vein of Galen, can occur in children.
  • Despite initial altered sensorium, conservative management without anticoagulation led to favorable outcomes in the reported cases.
  • Preservation of the ICVs and vein of Galen during surgery is crucial.

Implications:

  • Neurosurgeons must exercise meticulous care to protect the deep venous system when operating on midline or intraventricular brain structures.
  • Increased awareness among neurosurgeons and neuroradiologists is necessary for early recognition and appropriate management of this complication.
  • This highlights the importance of respecting venous anatomy during pediatric neurosurgical procedures to prevent potentially serious complications.

Keywords:
Internal cerebral veinPediatric neurosurgeryPostoperative deep brain venous thrombosisThrombosisVein of Galen

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