Cerebral Venous Sinus Thrombosis Associated with Immune Thrombocytopenic Purpura: A Case Report

Karen DV. Hernandez, Ma. Angelina L. Mirasol and Maria Cristina Z. San Jose

Department of Neurosciences, College of Medicine and
Philippine General Hospital, University of the Philippines Manila

Cerebral venous sinus thrombosis (CVST) constitutes a rare but serious stroke mechanism associated with hypercoaguable states. Immune thrombocytopenia (ITP) is a common hematologic disorder that results in an increased bleeding risk. CVST on the background of thrombocytopenia could be considered a clinical paradox. The co-existence of hyper and hypocoagulable states create management dilemmas. We present the case of an 18-year-old male hospitalized for sudden severe headache and seizures. Thrombosis of the sagittal sinus was confirmed with angiography. Work up of the persistently low platelet count revealed ITP. He was given medical decompression and steroids, with note of subsequent improvement in his functional status and platelet count.

Key Words: venous thrombosis, thrombocytopenia, headache