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Pseudotumor cerebri. A complication of catheter-induced subclavian vein thrombosis
B G Birdwell1, R Yeager, T L Whitsett
1Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.
Insights
Pseudotumor cerebri can indicate dangerous cerebral venous thrombosis. This case highlights catheter-related thrombosis causing this condition, emphasizing early diagnosis and treatment for better outcomes.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Pseudotumor cerebri (idiopathic intracranial hypertension) is a neurological condition characterized by increased intracranial pressure without a clear cause.
- Cerebral venous thrombosis (CVT) is a serious condition involving blood clots in the brain's venous sinuses, potentially leading to severe neurological deficits or death.
- Central venous catheters are common medical devices used for administering fluids, medications, and monitoring in critically ill patients.
Observation:
- A patient presented with symptoms suggestive of pseudotumor cerebri.
- Diagnostic imaging revealed thrombosed dural venous sinuses, indicating cerebral venous thrombosis.
- The venous thrombosis was found to have originated from a catheter-related thrombus in the subclavian vein.
Findings:
- This case demonstrates a direct link between subclavian vein thrombosis, secondary to central venous catheter use, and the development of pseudotumor cerebri.
- The propagation of the thrombus from the subclavian vein to the dural venous sinuses was the causative mechanism.
- Early recognition of this complication is crucial for timely intervention.
Implications:
- Pseudotumor cerebri should be considered a potential warning sign for underlying cerebral venous thrombosis, especially in patients with central venous catheters.
- Central venous catheter placement requires careful monitoring for potential thrombotic complications.
- Prompt diagnosis and treatment of catheter-related thrombosis can prevent severe neurological sequelae associated with CVT and pseudotumor cerebri.
Abstract:
Pseudotumor cerebri is frequently the only clinical clue to the presence of cerebral venous thrombosis, a potentially devastating condition. We report a case of pseudotumor cerebri associated with thrombosed dural venous sinuses caused by propagation of a catheter-related subclavian vein thrombus. The findings and clinical course in this case alert us to a complication of central venous catheter use that responds well to treatment if recognized early.