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Traumatic bilateral deep cerebral venous thrombosis: illustrative case
Callum D Dewar1,2, Maureen Scarboro2,3, Cara Lomangino2,3
1Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland.
Journal of Neurosurgery. Case Lessons
|June 9, 2025
Summary
This case highlights the first instance of isolated deep cerebral venous thrombosis (DCVT) after trauma. Early diagnosis and anticoagulation therapy improved symptoms in a young male patient.
Area of Science:
- Neurology
- Radiology
- Trauma Surgery
Background:
- Deep cerebral venous thrombosis (DCVT) is a rare condition, especially when occurring in isolation following trauma.
- Delayed or untreated DCVT can lead to severe neurological deficits and increased mortality rates.
Purpose of the Study:
- To report the first case of isolated traumatic bilateral DCVT.
- To emphasize the importance of venous imaging in specific trauma scenarios.
Main Methods:
- A 19-year-old male presented with symptoms 4 days post-motor vehicle accident.
- CT scan raised suspicion for DCVT, confirmed by CT venogram.
- MRI revealed venous congestion in bilateral thalami.
Main Results:
- The patient's symptoms, including headache and lethargy, improved with anticoagulation therapy.
- The case was identified as the first documented instance of isolated traumatic bilateral DCVT without hypercoagulable state or mass lesion.
Conclusions:
- Dedicated venous imaging is crucial in high-impact traumatic brain injury when initial scans are inconclusive and symptoms suggest further investigation.
- This case underscores the need for considering DCVT in trauma patients with neurological symptoms, even without typical risk factors.
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