Cerebral venous sinus thrombosis as the initial presentation of occult adult leukemia

Shu-Yi Chen ； Tzu-Chiang Yang ； Chung-Wen Chen ； Hung-Yi Hsu

《童綜合醫學雜誌》 16卷2期 (2022/12) Pp. 73-76

https://doi.org/10.4103/ETMJ.TMJ-110020

摘要

In this report, we present a rare case of cerebral venous thrombosis (CVT) as the initial presentation of hematological malignancy. A 49-year-old woman visited our hospital due to a progressive headache for 3 weeks. Brain imaging studies revealed edema in the right thalamus and bilateral caudate nuclei and acute thrombosis in the straight and right transverse sinuses. Initial laboratory investigations revealed only mild anemia and were negative for coagulopathy or autoimmune diseases. The patient had a complete recovery after anticoagulation therapy. Unfortunately, acute quadriparesis and coma occurred after warfarin was stopped for 3 months. Magnetic resonance imaging showed acute thrombosis of the basilar artery with brainstem infarction. At 11 months after the first presentation, acute leukemia was diagnosed due to marked leukocytosis and immature myeloblast cells in the peripheral blood. Bone marrow examination should be performed in patients with CVT with unexplained anemia. A continuous search for CVT causes after the acute phase is essential for patients with CVT.

關鍵字

Anemia ； cerebral venous thrombosis ； leukemia