Crescent-shaped intracranial hemorrhage in cerebral venous sinus thrombosis: A case report and review of literature

Abstract

Cerebral venous sinus thrombosis (CVST) is a rare but serious condition involving blood clots in the cerebral venous system often linked to prothrombotic states. It can result in complications such as intracranial hemorrhage and neurological deficits. We present the case of a 16-year-old female with CVST affecting the superior sagittal sinus, who experienced severe headaches and seizures. Initial computed tomography imaging showed a hematoma in the right frontal lobe, suggesting sinus and cortical vein thrombosis. Magnetic resonance imaging, magnetic resonance angiography, and magnetic resonance venography confirmed subacute hemorrhage with perifocal edema, and cerebral angiography validated the diagnosis. Elevated D-dimer levels supported the findings. The patient was treated with fondaparinux and later transitioned to oral warfarin, leading to clinical improvement and reduced D-dimer levels within a week. This case highlights the importance of early diagnosis and anticoagulation therapy, even in hemorrhagic cases, to prevent long-term complications and emphasizes the need for awareness of CVST in similar scenarios.

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