Cerebral Venous Thrombosis: A Mimic of Brain Metastases in Colorectal Cancer Associated with a Better Prognosis

Abstract

Malignancy is known to be one of the predisposing factors of cerebral venous thrombosis (CVT) due to its hypercoagulable state. CVT is a rare disorder which can lead to frequent misdiagnoses of brain metastases in such cases. We report here the case of a 35-year-old female with metastatic colon adenocarcinoma presenting with sudden neurological symptoms. Brain MRI and magnetic resonance venography confirmed the presence of CVT. She was treated with low molecular weight heparin followed by warfarin. She recovered and is doing well on warfarin after 5 months of diagnosis of CVT. CVT should be strongly suspected as a cause of neurological dysfunction in any case of disseminated malignancy including colon adenocarcinoma. Rapid diagnosis and initiation of therapy should be considered because of its favourable outcome.

Role of Decompressive Craniectomy in the Management of Cerebral Venous Sinus Thrombosis

“…It manifests as headache (in 75–95% of cases), seizures, papilledema, altered consciousness, and focal neurological deficits (1–4). CVST is the least common form of acute cerebrovascular disease, accounting for just 0.5% of all types of stroke (5–7). However, this figure rises to 15% of all young strokes in the Asian population (8, 9).…”

Cerebral Venous Thrombosis in the Setting of Malignancy: Case Report and Review of the Literature

“…The existing literature on agent of choice for cancer-related CVT is primarily found in case reports. Several reports have been published demonstrating safety and positive outcomes of various anticoagulation regimens including heparin, LMWHs, and VKAs ( Table 1 ) [ 1 , 5 , 12 , 13 – 17 , 18 – 31 ]. LMWHs have for several years been recommended over VKAs in malignancy-related VTE leading to the question of their superiority in malignancy-related CVT [ 32 ].…”

An Unusual Cause of Subacute Headache in a Patient Undergoing Chemotherapy for Advanced Testicular Nonseminomatous Germ Cell Tumour

“…He had no family history of recurrent venous thromboembolism or miscarriage in female relatives. CVST has been previously described as occurring in various malignancies including cervical cancer [ 10 ], colorectal cancer [ 11 ], and Ewing's sarcoma [ 12 ]. In keeping with the features of our case, CVST occurring early after the commencement of BEP chemotherapy has been described [ 13 ], perhaps mainly attributable to the direct vascular endothelial toxicity of cisplatin.…”