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A case with cerebral thrombosis receiving tamoxifen treatment
Author(s) -
Akdal G.,
Dönmez B.,
Çakmakçı H.,
Yener G. Gülmen
Publication year - 2001
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1046/j.1468-1331.2001.00297.x
Subject(s) - medicine , thrombosis , breast cancer , superior sagittal sinus , tamoxifen , magnetic resonance imaging , stroke (engine) , surgery , venous thrombosis , radiology , cancer , mechanical engineering , engineering
Cerebral sinus thrombosis (CST) is known to be related to a number of underlying aetiologies including otitis media, trauma, pregnancy, birth control pills, tumours, malnutrition, dehydration, haematologic disorders and malignancy (Fishman, 2000; Raizer and Abbott, 2000). We present the case of a patient with breast cancer receiving the antioestrogen drug tamoxifen who developed CST. A 40‐year‐old female presented as an emergency with a 10‐day history of headache and left sided weakness. On questioning her past medical history included a diagnosis of breast cancer 3 years ago treated by radical mastectomy and tamoxifen 20 mg daily. At the time of admission, neurologic examination revealed a mild left sided hemiparesis and a present Babinksi sign. Non‐contrast enhanced tomography was normal. Magnetic resonance imaging (MRI) showed thrombosis in the superior sagittal sinus, right lateral sinus and jugular vein in addition venous infarction in the right temporal lobe was present ( Figs 1a and b). Routine haematology and biochemistry was normal. Anticoagulation tests, antithrombin III, protein S and C levels were also found to be normal. She was treated with anticoagulation therapy and her hemiparesis improved within 3 days. Control MRI showed the resorption of the venous infarction and resolution of the thrombosis ( Fig. 1c). 1 T1 weighted contrast enhanced axial (a) and coronal (b) images show unenhancing thrombus in superior sagittal sinus and venous heamorrhagic infarction in the right temporal lobe. Control T1 weighted contrast enhanced MRI image (c) reveals resolution of the thrombus in superior sagittal sinus.