Cerebral venous thrombosis due to heparin-induced thrombocytopenia.

Abstract

A patient with polycythemia vera who was treated with heparin for superficial septic thrombophlebitis developed heparin-induced thrombocytopenia and cerebral venous thrombosis with superior sagittal sinus occlusion 11 days after the institution of heparin therapy. We suggest that the severe thrombotic response to the heparin-induced platelet disorder in this patient occurred because the polycythemia vera and the purulent infection enhanced the thrombophilia caused by heparin-induced thrombocytopenia. This condition can be avoided in most instances if heparin is used for no longer than 5 days. {Stroke 1990:21:1503-1505)

Reversible Corpus callosum Lesions in a Patient with Marchiafava-Bignami Disease: Serial Changes on MRI

“…There have been a few reports regarding spared naming without com prehension [4,5]. These cases including ours have a theoretical importance.…”

Fatal Cerebral Venous Sinus Thrombosis in Heparin-Induced Thrombotic Thrombocytopenia

“…This is called HITT and carries a mortality of 30% [3]. It is believed to be caused by antibodies directed against a heparin-platelet membrane complex, leading to platelet aggregation [4], Clinical criteria pro posed for HITT are summarized in table 1. According to them, our patient had 'definite' HITT.…”

“…We are aware of four other cases in the literature [3,4,8,9], The fatal outcome should serve as a reminder that heparin therapy must be closely monitored for the rare, but dangerous complication of HITT, especially in the 2nd week. Marchiafava-Bignami disease (MBD) is an uncommon disorder associated with alcoholism, presumably with nutritional or metabolic origin.…”

“…largely due to an increase in the proton content in the tissue water. Therefore, the loss of myelin alone is unlikely to affect the MRI intensity because the lipid proteins in myelin make only a negligible contribution to the normal brain signal [4], In fact. MRI can fail to detect pathologically confirmed dcmyelination caused by a rapid correction of hyponatremia.…”

Sinusvenenthrombose

“…Eine Sinusvenenthrombose mit der dazu gehörenden klinischen Symptomatik als Folge einer HIT II ist unseres Wissens in der Literatur selten beschrieben [5,11,14,17,24,26,28,30].…”