Abstract
Background and Aim: The coexistence of cerebral venous thrombosis (CVT) and hematological neoplasms is
rare. Currently available therapeutic options raise problems concerning the balance
of thrombotic and hemorrhagic risks. Our purpose is to characterize a series of cases
of CVT and concomitant hematological malignancy, focusing on predisposing factors
and treatment strategies. Methods: We performed a descriptive retrospective analysis of the cases of CVT and hematological
neoplasms diagnosed in a tertiary center from 2006 to 2015. Results: From the 111 CVT cases diagnosed, only 7 coexisted with hematological malignancy
(lymphoma, leukemia, multiple myeloma, and myelodysplastic syndromes). These included
4 women; median age was 44 years old. Median follow-up time was 72 days. The hematological
condition was already known in 5 cases. Besides malignancy, we identified other prothrombotic
conditions in all cases. Several anticoagulant strategies were used during the acute
phase, after which 5 patients remained on warfarin indefinitely. One patient died
due to cerebral hemorrhage during the acute phase. In the remaining 6 patients, there
was no recurrence of CVT or other complications of anticoagulation. Conclusions: Although these results reiterate the role of hematological malignancy as predisposing
factor to CVT, in all cases other factors contributed to CVT etiology, potentiating
the risk. We report 1 death directly attributable to a fatal hemorrhagic complication
of anticoagulation, evidencing the delicate balance of thrombotic and hemorrhagic
risk. Nevertheless, most patients benefited of long-term anticoagulation, which proved
a reasonable option. A multidisciplinary approach is paramount in making decisions
regarding the time and type of anticoagulation.
Key Words
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Article info
Publication history
Published online: February 11, 2020
Accepted:
January 18,
2020
Received in revised form:
December 16,
2019
Received:
September 30,
2019
Footnotes
Funding: None.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104683
Copyright
© 2020 Elsevier Inc. All rights reserved.
