Acute Dural Sinus Thrombosis Following Ingestion of an Herbal Tonic: Case Report

Objective: The use of herbals and health supplements is not without risk. This case report of a 17-year-old girl who presented with acute dural sinus thrombosis following herbal tonic ingestion illustrates the dangers of unsupervised ingestion of “health supplements.” Subject and Methods: A 17-year-old girl with normal menses and no prior medical history, procoagulant risk factors, or oral contraceptives use, presented following ingestion of herbal liquid for 2 days, with signs and symptoms of dural sinus thrombosis confirmed by CT scan. MRI and MRV showed bilateral transverse sinuses thrombosis. The patient had an extensive workup, and all procoagulant disorders or factors, including Behcet’s disease, were ruled out. The temporal profile of the ingestion of herbal fluid may suggest association with the development of sinus thrombosis. Conclusion: Combinations of herbs in dietary or health supplements could potentiate their subclinical procoagulant effects, and this case highlights the need to report such serious central nervous system adverse effects associated with the ingestion of herbal preparations.

Key Words: Dural sinus thrombosis, traditional medicine, health supplements, cortical vein thrombosis, herbals