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

Table 1

Review of the literature describing sinus thromboses in malignancies.

Reference	Number of patients	Cancer	Anticoagulant	Duration of therapy	Outcome
Oda et al.[15]	1	Stage IV lung adenocarcinoma	Heparin, warfarin	4 weeks	Radiographic resolution at 4 weeks
Iqbal and Sharma[13]	1	Metastatic colorectal adenocarcinoma	LMWH, warfarin	5 months	Clinical improvement in symptoms at 5 months
Mutreja et al.[14]	1	JAK2V617F mutation-positive hematolymphoid malignancy	Heparin, warfarin, dabigatran	21 days	Death at 21 days
Tuncel et al. [16]	1	Advanced-stage small cell lung cancer	LMWH	N/A	Clinical improvement at 1 month
Marvin et al. [3]	1	Metastatic renal cell carcinoma (brain metastases)	Heparin	N/A	Radiographic resolution and death at 4 months (unknown cause)
Shimizu et al. [17]	1	Tongue cancer	Heparin	N/A	Clinical and radiographic improvement
Akai et al. [18]	1	Malignant melanoma with meningeal dissemination	Urokinase, heparin	24 hours	Recanalization of straight sinus
Ho et al. [19]	1	Acute lymphoblastic leukemia	Heparin, warfarin	N/A	Radiographic resolution at 20 days
Vargo et al. [1]	1	Anaplastic gemistocytic astrocytoma	Heparin, enoxaparin	N/A	Stabilization and interval improvement on MRI
Eudo et al. [5]	1	Multiple myeloma	LMWH	N/A	Clinical improvement in symptoms at 1 month
Li et al. [20]	1	Grade 2, stage IIIC serous ovarian cancer	Enoxaparin	5 weeks	Death at 5 weeks
Chang et al. [21]	1	Acute myeloid leukemia, M1	Enoxaparin, warfarin	N/A	Clinical improvement in vision
Wang et al. [22]	1	Acute lymphoblastic leukemia	Enoxaparin	7 months	Clinical and radiographic improvement at six months
Iurlaro et al. [23]	9	Breast cancer x2, gastric cancer, NHL x3, HL, kidney cancer and melanoma, and rhinopharyngeal cancer	Unfractionated , LMWH	N/A	Based off of modified Rankin scale (mRS): complete recovery in 4 patients (mRS 0), mild sequelae in 4 patients (mRS 1-2), and moderate sequelae in one patient (mRS 3)
Karam and Koussa [24]	2	Germ-cell carcinoma of the testis; poorly differentiated pericardial carcinoma	Unknown anticoagulation; heparin	20 days	Clinical and radiographic improvement at 1 month; unknown outcome
Ross et al. [25]	4	T-cell ALL; pre-B-cell ALL; ALL; pre-B-cell ALL	LMWH; unfractionated heparin, LMWH, warfarin; LMWH; LMWH	7 months; n/a; 3 months; 4 months	Radiographic partial recanalization; clinical improvement in symptoms; complete resolution on imaging at 1 month; resolution on imaging at 1 month
Song et al. [26]	1	Acute promyelocytic leukemia	LMWH, warfarin	N/A	Radiographic recanalization of straight sinus with continued occlusion of transverse and confluens sinuum at 1 month
Imamura et al. [27]	2	B-precursor ALL; T-cell type NHL	No anticoagulation; LMWH; ATIII concentrate supplementation	N/A; N/A	Death at 40 days; complete neurologic recovery
Lee et al. [28]	1	Acute lymphoblastic leukemia	Heparin, warfarin	N/A	Radiographic recanalization of the superior sagittal sinus
Ciccone et al. [29]	1	Acute promyelocytic leukemia	Unfractionated heparin, warfarin		Complete recovery from the coma and almost complete resolution of the sinuses thrombosis.
Motohashi et al. [30]	1	Acute myeloid leukemia	Heparin, warfarin	N/A	Recanalization of straight sinus but continued occlusion of the right transverse and sigmoid sinuses. No neurologic sequelae at 10 months
Corso et al. [31]	2	Ph + ALL; Ph + ALL	Heparin; heparin	N/A; N/A	Radiographic resolution of thrombus; progressive but slow resolution of symptoms