Thrombosis of the Vein of Galen: Pitfalls, Metamorphosis, and Paroxysmal Sympathetic Hyperactivity

Abstract

Isolated thrombosis of the vein of Galen is a rare and serious entity with few cases reported in the literature. We report the case of a previously healthy 18-year-old male who was admitted after developing headache and subsequently worsening mental status, requiring endotracheal intubation for airway protection. During his admission he developed symptoms of severe paroxysmal sympathetic hyperactivity and posturing. The computed tomography and magnetic resonance imaging of the brain showed bilateral thalamic lesions. The magnetic resonance angiography and digital arteriography revealed a thrombosis of the deep cerebral venous system (vein of Galen). We call attention to a case with rapid symptom progression and specific radiological findings, with atypical clinical course, characterized by paroxysmal sympathetic hyperactivity, but with good clinical functional outcome.

Stroke with postoperative visual loss as the first clinical manifestation of antiphospholipid antibody syndrome: Case report

“…Ischemic stroke and transient ischemic attacks are the most common arterial events in patients with APS. The most common venous thrombotic events involve deep-vein thrombosis or pulmonary embolism [8] .…”

Sinus- und Hirnvenenthrombose

“…Bei ausgeprägten Sinus- oder Hirnvenenthrombosen mit generalisiertem Hirnödem

generalisiertem Hirnödem

oder bei Affektion der unpaaren V. cerebri magna Galeni mit konsekutiver Stauung im Bereich beider Thalami („innere Hirnvenenthrombose“), wie im o. g. Fallbeispiel, kann es zu ausgeprägten Bewusstseinsstörungen

Bewusstseinsstörungen

mit Notwendigkeit einer Schutzintubation kommen[ 14 ].…”