Open AccessChemotherapy associated dural sinus thrombosis presenting as a cerebrospinal fluid leak
Author(s) -
Iulia Bujoreanu,
Mark Ferguson,
Hesham Saleh
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235240
Subject(s) - medicine , dural venous sinuses , cerebrospinal fluid , surgery , thrombosis , chemotherapy , venous thrombosis , leak , acetazolamide , sinus (botany) , cerebrospinal fluid leak , pseudotumor cerebri , cerebral venous sinus thrombosis , thrombus , intracranial pressure , anesthesia , botany , environmental engineering , engineering , biology , genus
Despite the well documented increased risk of thrombosis in patients with cancer and during chemotherapy, cerebral venous sinus thrombosis (CVT) remains a rare entity. We present a rare case of cerebrospinal fluid (CSF) rhinorrhoea secondary to a left transverse sinus thrombus which occurred 2 years previously during chemotherapy for breast cancer. The patient underwent a three-layer repair using Neuro-Patch, septal cartilage and middle turbinate pedicle flap and was started on acetazolamide. There was no recurrence at 1-year follow-up. Raised intracranial pressure secondary to cerebral venous occlusion can erode the base of skull and predispose to CSF leaks. Despite the theoretical risk, there have been no cases reported where CSF leaks have occurred following chemotherapy induced CVT. We describe the first case and discuss pathophysiology and management.