A Case Report of Cerebral Venous Thrombosis in Polycythemia Vera Presenting with Intracranial and Spinal Subdural Hematoma

Sirin N. G., Yesilot N., Ekizoglu E., Keles N., Tuncay R., Coban O., ...More

CASE REPORTS IN NEUROLOGY, vol.2, no.2, pp.37-45, 2010 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 2 Issue: 2
  • Publication Date: 2010
  • Doi Number: 10.1159/000313953
  • Journal Name: CASE REPORTS IN NEUROLOGY
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Page Numbers: pp.37-45
  • Keywords: Cranial subdural hematoma, Spinal subdural hematoma, Concomitant, Cerebral venous thrombosis, Polycythemia vera
  • Istanbul University Affiliated: Yes

Abstract

Spinal subdural hematoma (SDH) is a rare condition and can be caused by several factors. Concomitant cranial and spinal SDH is even much less common. We present a 77-year-old male patient with lower back pain, paraparesis, and urinary retention following a sudden onset headache. Imaging revealed concomitant cranial and spinal SDH related to cerebral venous thrombosis (CVT) associated with hemorrhagic venous infarct. Laboratory examinations were consistent with polycythemia vera. There was no history of trauma and previous cranial surgery. Brain angiography did not reveal any evidence of arteriovenous fistula or vascular malformation. Since lower back pain occurred shortly after the headache and there was no other reasonable explanation for spinal hemorrhage, we suppose that the mechanism of spinal SDH is the migration of blood from the intracranial compartment. Therefore, this is the first report of concomitant spinal SDH and cerebral hemorrhage associated with CVT in a patient with myeloproliferative disease.