Isolated straight sinus thrombosis

Abstract

A woman in her 50s with history of breast cancer on Tamoxifen presented with altered mental status. Patient was unresponsive, had preserved pupillary light response with small pupils, and localized to noxious stimuli in upper extremities with triple flexion in the lower extremities. A.Brain tumorB.Venous sinus thrombosisC.Dural arteriovenous fistulaD.Basal ganglia calcification A head CT was performed (Fig. 1A) and a CT venogram showed isolated straight sinus thrombosis. Heparin was initiated and patient was taken to the interventional neuroradiology suite. An attempted thrombectomy was unsuccessful (Fig. 1B). A brain MRI was performed 2 days later (Fig. 1C and D). Patient showed rapid neurological decline and expired 5 days later. Isolated straight sinus thrombosis is a rare condition associated with a very poor prognosis [[1]Valeriano J. Bhagavatula K. Ku A. Snyder P.J. Isolated straight sinus thrombosis: clinical and neuroradiologic correlates.J Neuroimaging. 1998; 8: 106-108PubMed Google Scholar]. Management include heparinization with a few reported cases of endovascular thrombolysis [[2]Gerszten P.C. Welch W.C. Spearman M.P. Jungreis C.A. Redner R.L. Isolated deep cerebral venous thrombosis treated by direct endovascular thrombolysis.Surg Neurol. 1997; 48: 261-266Abstract Full Text PDF PubMed Scopus (52) Google Scholar]. No conflict of interests by any of the authors.