Cerebral Venous Thrombosis in the Setting of Malignancy: Case Report and Review of the Literature

Abstract

Cerebral venous thrombosis (CVT) is a rare condition that can be difficult to diagnose due to its vague and nonspecific symptoms. It is even more unusual to identify CVT in association with malignancy. Given the rarity of this disease, treatment and management of CVT in the setting of malignancy is not well defined. This case report and review of the literature addresses the epidemiology, pathophysiology, and medical treatment for malignancy-related CVT.

Cerebral venous sinus thrombosis with venous hemorrhagic infarct in a patient with high-grade glioma of the left thalamus

“…CVST is an uncommon type of VTE [1][2][3][4]. The incidence of CVST was about 0.3-4% in cancer patients, with cancer increasing risk for CVST roughly 5-fold [5,7]. Extracranial VTE events such as deep venous thrombosis and pulmonary embolism have been widely reported in HGG; however, the incidence of CVST in HGG patients is not well established in the literature [4,5].…”

“…The incidence of CVST was about 0.3-4% in cancer patients, with cancer increasing risk for CVST roughly 5-fold [5,7]. Extracranial VTE events such as deep venous thrombosis and pulmonary embolism have been widely reported in HGG; however, the incidence of CVST in HGG patients is not well established in the literature [4,5]. According to a recent study, the incidence of CVST in glioblastoma multiforme patients was reported to be 7.4% [3].…”

“…CVST results in venous hypertension and the resultant cerebral edema can cause a range of symptoms such as nausea, vomiting, headache, seizures, and focal neurologic deficits [4,5,9]. These symptoms are highly non-specific and are usually attributed to the underlying brain tumor; this is the reason why many reports estimated an approximate 7-day delay between the onset of symptoms and the diagnosis [9].…”

“…Cerebral venous sinus thrombosis (CVST) is an uncommon type of VTE whose diagnosis is often difficult due to its vague and non-specific clinical findings [1,4,5]. Sometimes, the diagnosis is delayed as the symptoms were considered to be attributable to the underlying etiology, especially in patients with HGG [5,6]. This case report highlights the case of a 60-year-old patient whose diagnosis of CVST was delayed as the symptoms were thought to be of the underlying brain tumor.…”

“…T he patients with high-grade glioma (HGG) carry a high risk of venous thromboembolism (VTE) [1][2][3]. Cerebral venous sinus thrombosis (CVST) is an uncommon type of VTE whose diagnosis is often difficult due to its vague and non-specific clinical findings [1,4,5]. Sometimes, the diagnosis is delayed as the symptoms were considered to be attributable to the underlying etiology, especially in patients with HGG [5,6].…”