The role of hyperthyroidism as the predisposing factor for superior sagittal sinus thrombosis

• Published in: Journal of cerebrovascular and endovascular neurosurgery Vol. 14; no. 3; pp. 251 - 254
• Main Authors: Hwang, Jong-Uk, Kwon, Ki-Young, Hur, Jin-Woo, Lee, Jong-Won, Lee, Hyun-Koo
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Cerebrovascular Surgeons; Korean Society of Endovascular Surgery 01-09-2012; 대한뇌혈관외과학회
• Subjects: Case Report; 신경외과학; Hypercoagulability; Superior sagittal sinus; Hyperthyroidism; Cerebral venous thrombosis
• ISSN: 2234-8565; 2287-3139
• DOI: 10.7461/jcen.2012.14.3.251

Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who developed seizure and mental deterioration. Findings on brain computed tomography (CT) showed multiple hemorrhages in the subcortical area of both middle frontal gyrus and cerebral digital subtraction angiography (DSA) showed irregular intra-luminal filling defects of the superior sagittal sinus. These findings were consistent with hemorrhagic transformation of SSST. Findings on clinical laboratory tests were consistent with hyperthyroidism. In addition, our patient also showed high activity of factors IX and XI. The patient received treatment with oral anticoagulant and prophylthiouracil. His symptoms showed complete improvement. A follow-up cerebral angiography four weeks after treatment showed a recanalization of the SSS. In conclusion, findings of our case indicate that hypercoagulability may contribute to development of SSST in a patient with hyperthyroidism.