Abstract

In childhood; the incidence of intracranial thrombosis is 2 5 2 7 100000 They may present with different symptoms according to the location and size of the occluded vessel and age of the patient In most cases; cranial imaging is necessary to confirm the lesion Pediatric cerebrovascular thrombosis may be related to more than one etiologic factor so detailed evaluation is mandatory A thirteen year old boy presented to our emergency room with a complaint of seizure His cranial imaging showed thrombosis in left transversesigmoid sinuse His father had been diagnosed to have deep venous thrombosis In our case and in his father; protein S levels were found as 11 9 and 10 6 N: 80 120 respectively and they were started on anticoagulation therapy Our patient’s homocsyteine level was 15 5 mmol lt N:0 12 His methylene tetrahydrofolate reductase thermolabile enzyme C677T mutation was found homozygous He was also started on oral folic acid therapy A year after his first presentation his protein S level was 16 and homocysteine level was 7 5 mmol lt His last cranial imaging showed no progresssion in the prior lesion and no new lesion Key words: childhood homocysteine methylene tetrahydrofolate reductase proteins thrombosis

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