Cerebrovascular intervention therapy worked positively in one patient with severe cerebral venous sinus thrombosis due to hyperthyroidism: a case report and review of the literature

Abstract

Background: With further understanding of cerebral venous sinus thrombosis, hyperthyroidism has gradually been revealed as a rare predisposing factor for cerebral venous sinus thrombosis, which may present as more compact clots and resistance to fibrinolysis, also known as a predictor of worse outcomes. For patients with severe cerebral venous sinus thrombosis, proper treatment method should be initiated as soon as possible since they may deteriorate rapidly. Case presentation: In this case report, we present a 32-year-old Mongoloid woman admitted with progressive headache, impaired consciousness, and right limb weakness, diagnosed with cerebral venous sinus thrombosis caused by hyperthyroidism. A cerebrovascular intervention with local thrombolytic infusion was performed at the site of thrombosis, followed by dilatation with balloon and thrombus aspiration in venous sinus, with partial recanalization observed and anticoagulation given as a next step. After cerebrovascular intervention, the patient’s condition improved rapidly and she was discharged with her National Institute of Health Stroke Scale score being decreased from 17 to 2. Conclusions: When patients with hyperthyroidism suffer from headache, progressive disturbance of consciousness, seizures, and other symptoms, the presence of cerebral venous sinus thrombosis should be considered and corresponding examinations should be performed as soon as possible. For patients with severe cerebral venous sinus thrombosis, cerebrovascular intervention might be a safe and effective approach if conventional management fails.