Postoperative dural sinus thrombosis in a patient in a hypercoagulable state: Case report

Bradley C. Lega, Daniel Yoshor

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Spontaneous cerebral venous sinus thrombosis is a rare problem that may be encountered in patients with underlying thrombophilic disorders. It has also been reported as a postoperative complication following suboccipital, transpetrosal, and transcallosal approaches. The authors report on a 67-year-old man with two prior episodes of lower-extremity deep venous thrombosis who underwent transcallosal resection of a colloid cyst and in whom sagittal sinus thrombosis developed 2 weeks thereafter. Results of a subsequent hematological workup revealed both a factor V Leiden mutation and the presence of antiphospholipid antibodies, two thrombophilic risk factors that likely contributed to the development of delayed postoperative sinus thrombosis. Although the safety of low-molecular-weight heparin (LMWH) after craniotomy has not been established in a randomized, controlled study, there is sufficient evidence to justify its use for prophylactic anticoagulation therapy in patients at high risk for postoperative cerebral venous thrombosis. The authors propose using LMWH prophylaxis in patients with thrombophilic disorders who undergo neurosurgical procedures in proximity to dural sinuses in an effort to prevent catastrophic venous infarction.

Original languageEnglish (US)
Pages (from-to)772-774
Number of pages3
JournalJournal of Neurosurgery
Volume105
Issue number5
DOIs
StatePublished - Nov 1 2006

Keywords

  • Factor v Leiden mutation
  • Heparin
  • Lupus anticoagulant
  • Sagittal sinus thrombosis
  • Transcallosal approach

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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