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Updated: Jul 2, 2025
08:22
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
15.0K
Post-lumbar puncture cerebral vein thrombosis.
Vincenzo Marasco1, Francesca Gianniello2, Aldo Paolucci3
1Department of Hematology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy.
Ejhaem
|February 26, 2024
Summary
Cerebral vein thrombosis (CVT) is a rare complication of lumbar puncture (LP), particularly with coexisting risk factors. This case suggests dabigatran may be a safe and effective treatment for CVT, even with subsequent hemorrhagic complications.
Area of Science:
- Neurology
- Hematology
Background:
- Cerebral vein thrombosis (CVT) is an uncommon complication following lumbar puncture (LP).
- Risk factors can increase the likelihood of CVT post-LP.
Observation:
- A 28-year-old woman developed severe headache and seizures after LP and corticosteroid treatment for suspected multiple sclerosis.
- Imaging confirmed superior sagittal sinus and cortical vein thrombosis.
- Thrombophilia screening revealed a G20210A prothrombin mutation.
Findings:
- Initial anticoagulant therapy with heparin and warfarin led to a subdural hematoma.
- Switching to dabigatran resulted in complete recovery from both thrombosis and hemorrhage.
- The patient experienced a full recovery from both thrombotic and hemorrhagic complications.
Implications:
- CVT should be considered in the differential diagnosis of persistent post-LP headaches.
- Dabigatran may represent a safe and effective treatment option for CVT, even in cases with hemorrhagic complications.
- This case underscores the importance of considering thrombophilia screening in patients with unexplained CVT.
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