The “Cord Sign” in Cerebral Venous Thrombosis Associated with High Plasma Levels of Factor VIII

Giraldo, Elias A.; Petrinjac-Nenadic, Rada

doi:10.1007/s12028-010-9434-2

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…CVST on non-contrast computed tomography (CT) of the head appears as a “cord sign”, which is basically thrombosed cortical veins [11]. This may provide a clue to clinicians of a potential diagnosis of CVST.…”

Section: Discussionmentioning

confidence: 99%

Elevated Factor VIII Level Associated with Transverse Cerebral Venous Sinus Thrombosis

et al. 2019

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Patient: Female, 50Final Diagnosis: Transverse cerebral venous sinus thrombosisSymptoms: Headache, diplopia, nausea, vomitingMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Rare diseaseBackground:Cerebral venous sinus thrombosis (CVST) is an uncommon cause of stroke. CVST can be caused by systemic conditions as well as mechanical factors that reduce blood flow to promote thrombosis. These can include hormonal therapies, pregnancy, malignancy, genetic conditions. trauma, neurosurgical procedures, and adjacent infections (mostly mastoiditis). This case report describes a patient with right transverse sinus thrombosis with no prior risk factors.Case Report:A 50-year-old female with no risk factors presented with complaints of headache associated with diplopia for 2 weeks. She did not have any other neurologic signs or symptoms. The patient initially underwent a cerebral magnetic resonance imaging that revealed right transverse sinus thrombosis. She underwent an extensive procoagulant workup and was found to have an increased factor VIII level. All other workups were negative. The patient was started on heparin infusion and bridged to coumadin to achieve a therapeutic international normalized ratio. The patient had improvement in her headache symptoms and was discharged to be followed as an outpatient.Conclusions:We report a case of right transverse sinus thrombosis in a patient with increased factor VIII levels. It is prudent to promptly diagnose cerebral sinus venous thrombosis and start antithrombotic treatment for complete resolution of symptoms.

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Section: Discussionmentioning

confidence: 99%

Elevated Factor VIII Level Associated with Transverse Cerebral Venous Sinus Thrombosis

et al. 2019

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“…Head magnetic resonance imaging is useful to characterize the lesions. Lumbar puncture is not routinely recommended 11…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis in a Child with Idiopathic Nephrotic Syndrome: a case report

et al. 2018

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Complications are rare in pediatric cases of idiopathic nephrotic syndrome (NS). Thromboembolism ranks among the most uncommon and difficult complications to diagnose, particularly in the first episode of NS, since clinical signs might be unspecific. This report describes the case of a 5-year-old girl with NS for the first time presenting with severe hypoalbuminemia (< 2g/dL). The patient responded poorly to therapy with corticosteroids. On day 8 of hospitalization she started having headaches and vomiting; she did not present hemodynamic alterations, fever or exanthems, and her neurological parameters were normal. The patient was suspected for intracranial hypertension, and computed tomography scans revealed she had cerebral venous sinus thrombosis (CVST). She was started on anticoagulants and showed clinical signs of improvement. The patient had no evident prothrombotic risk factors. She had three other episodes since she was diagnosed, one in which her plasma antithrombin level was low. Although antithrombin levels were normal in her first episode, she was tested after the resolution of proteinuria. The low levels of antithrombin seen in the first recurrence might have mirrored the initial drop in plasma antithrombin levels, an idea supported by the severe hypoalbuminemia she had when diagnosed. This severe manifestation of acquired thrombophilia might be in the origin of CVST. This report presents a rare case of thromboembolic complication in a pediatric patient with NS. The patient progressed well since she was started on anticoagulants. Although she did not present any evident risk factors at first, the development of her case indicated that severe acquired thrombophilia might have worked as the pathophysiological mechanism leading to CVST.

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Cerebral Venous Thrombosis

Sharpe

Pasternak

2017

Essentials of Neuroanesthesia

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The “Cord Sign” in Cerebral Venous Thrombosis Associated with High Plasma Levels of Factor VIII

Abstract: We report the first case of CVT with the "cord sign" and concomitant elevated FVIII. Early recognition of the "cord sign" is warranted for the emergency diagnosis and treatment of CVT.

Cited by 5 publications

References 8 publications

Elevated Factor VIII Level Associated with Transverse Cerebral Venous Sinus Thrombosis

Elevated Factor VIII Level Associated with Transverse Cerebral Venous Sinus Thrombosis

Cerebral Venous Sinus Thrombosis in a Child with Idiopathic Nephrotic Syndrome: a case report

Cerebral Venous Thrombosis

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