Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Sep;97(36):e11587.
doi: 10.1097/MD.0000000000011587.

A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma: Case report

Haiyan Zheng  1 , Weilin Xu, Yili Chen, Shiying Gai, Gao Chen
Affiliations
Case Reports

A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma: Case report

Haiyan Zheng et al. Medicine (Baltimore). 2018 Sep.

Abstract

Rationale: Deep cerebral venous thrombosis (DCVT) is a rare disease, but always results in poor prognosis.

Patient concerns: We reported a 79-year-old female with coma after traumatic brain injury (TBI).

Diagnosis: The epidural hematoma was first diagnosed on non-contrast computerized tomography (CT). The hypodense areas in bilateral thalami and basal ganglia on reexamination CT highly indicated the suspicion of DCVT. Finally, the appearance of thrombosis of the vein of Galen on the computed tomography venography (CTA) and digital subtraction angiography (DSA) confirmed the diagnosis.

Interventions: The patients received surgery to remove the epidural hematoma. After that, she was treated with oral anticoagulation agent (low molecular weight heparin (LMWH), 180 Axal U/kg 24 h) for 4 weeks, shifted by oral warfarin (2.5 mg qd) for 4 weeks.

Outcomes: The hypodense areas in bilateral thalami and basal ganglia have been largely reversed. At the time of 6 months after surgery, the patient could take care of herself.

Lessons: If the CT shows hypodense areas in bilateral thalami and basal ganglia, a diagnosis of DCVT should be suspected once the patients could not recover from the treatment of primary diseases.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The preoperative imagings of the patient. (A) Preoperative CT revealed a large hyperdense epidural hematoma and ill-demarcated hypodense areas in bilateral thalami and basal ganglia; (B) CT postoperative CT showed the hematoma has been successfully removed, but the hypodense areas in bilateral thalami and basal ganglia were more clearly showed on the image; (C) CTA revealed the thrombosis of vein of Galen; (D) DSA showed the thrombosis of vein of Galen. CT = computed tomography, CTA = computed tomography venography.
Figure 2
Figure 2
The postoperative imagings of the patient. (A, B) CTA revealed recanalization of vein of Galen after the treatments; (C) noncontrast CT 1 month after operation showed that the hypodense areas in bilateral thalami and basal ganglia have been largely reversed. CT = computed tomography, CTA = computed tomography venography.
See this image and copyright information in PMC

References

    1. Bousser MG, Ferro JM. Cerebral venous thrombosis: an update. Lancet Neurol 2007;6:162–70. - PubMed
    1. Feroze AH, Mantha A, Choudhri O. Deep cerebral venous thrombosis during pregnancy. Br J Neurosurg 2014;5:1–2. - PubMed
    1. Benifla M, Laughlin S, Tovar-Spinoza ZS, et al. Unilateral postoperative deep cerebral venous thrombosis with complete recovery: a report of 2 cases. Pediatr Neurosurg 2017;52:205–10. - PubMed
    1. Pires A, Rocha S, Rodrigues M, et al. Deep cerebral venous thrombosis: a challenging diagnosis. Arq Neuropsiquiatr 2011;69:563–5. - PubMed
    1. Ribes MF. Des recherches faites sur la phlebite. Rev Med Francaise Etrangere J Clin l’Hotel-Diou Char Paris 1825;3:5–41.

Publication types