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Recurrent Idiopathic Cerebral Venous Thrombosis
Melissa Tebaldi1, Zackary Anderson1, Darion Lago1
1Internal Medicine, Naples Comprehensive Health, Naples, USA.
Cureus
|July 18, 2025
Summary
This case highlights a rare instance of cerebral venous thrombosis (CVT) with reaccumulating clots despite mechanical thrombectomy and external ventricular drain placement, emphasizing the need for better risk stratification tools in managing complex CVT cases.
Area of Science:
- Neurology
- Vascular Neurology
Background:
- Cerebral Venous Thrombosis (CVT) is a rare but serious neurological condition.
- Beta-thalassemia minor is a genetic blood disorder that may present unique challenges in vascular cases.
Observation:
- A 40-year-old female with beta-thalassemia minor presented with intractable headache, nausea, and vomiting.
- Initial CT head was negative; however, cerebral venous thrombosis (CVT) was diagnosed 48 hours later.
- The patient experienced persistent intracranial pressure (ICP) elevation despite mechanical thrombectomy and external ventricular drain (EVD) placement.
Findings:
- Mechanical thrombectomy and EVD placement were insufficient to manage the rising ICP in this CVT case.
- Repeat thrombectomy was unsuccessful due to reaccumulating clot burden, a phenomenon not previously documented in literature.
- Current diagnostic and management tools lack efficacy for complex CVT cases with recurrent thrombosis.
Implications:
- This case underscores the critical need for improved imaging modalities and early diagnosis of CVT based on high clinical suspicion.
- Further research is required to develop better risk stratification tools and quantifiable measures for improved patient outcomes in CVT.
- The reaccumulation of clot burden despite intervention highlights a gap in understanding and managing refractory CVT.
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