Advertisement

Primary cerebral venous thrombosis in patients with cancer—A rarely diagnosed paraneoplastic syndrome

Report of three cases and review of the literature
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Idiopathic thrombosis of the cerebral venous structures is a rare complication of malignancy. The clinical, radiologic, pathologic, and laboratory findings in the 15 previously reported cases are reviewed, and three additional cases are reported. The clinical syndrome that develops in such patients is similar to that seen in other patients with cerebral venous or sinus thrombosis. However, the diagnosis is often not made clinically because cerebral involvement by neoplastic disease provides a more common and readily acceptable explanation of the observed phenomena. If venous thrombosis involving the brain is suspected, angiography provides the only certain method of diagnosis. The relationship of this thrombotic process to a cancer-associated hypercoagulable state is discussed.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ganick DJ
        • Robertson WC
        • Visekul C
        • Lubinsky MS
        Dural sinus thrombosis in leukemia.
        Am J Dis Child. 1978; 132: 1040-1041
        • Sigsbee B
        • Deck MDF
        • Posner JB
        Non-metastatic superior sagittal sinus thrombosis complicating systemic cancer.
        Neurology (NY). 1979; 29: 139-146
        • Plum F
        • Posner JB
        The diagnosis of stupor and coma.
        in: 3rd ed. Contemporary neurology. 19. F.A. Davis, Philadelphia1980: 138-142
        • Zilkha A
        • Diaz AS
        Computed tomography in the diagnosis of superior sagittal sinus thrombosis.
        J Comput Assist Tomogr. 1980; 4: 124-126
        • Priest JR
        • Ramsey NKC
        • Latchaw RE
        • et al.
        Thrombotic and hermorrhagic strokes complicating early therapy for childhood acute lymphoblastic leukemia.
        Cancer. 1980; 46: 1548-1554
        • Posner JB
        • Schori M
        Cerebrovascular complications of cancer.
        Clin Bull. 1980; 10: 158-163
        • Lockman LA
        • Mastri A
        • Priest JR
        • Nesbit M
        Dural venous sinus thrombosis in acute lymphoblastic leukemia.
        Pediatrics. 1980; 66: 943-947
        • Kalbag RM
        • Woolf AL
        Cerebral venous thrombosis: with special reference to primary aseptic thrombosis.
        Oxford University Press, New York1967
        • Krayenbuhl HA
        Cerebral venous and sinus thrombosis.
        Clin Neurosurg. 1966; 14: 1-24
        • Lorincz AB
        • Moore RY
        Puerperal cerebral venous thrombosis.
        Am J Obstet Gynecol. 1962; 83: 311-318
        • Averback P
        Primary cerebral venous thrombosis in young adults: the diverse manifestations of an underrecognized disease.
        Ann Neurol. 1978; 3: 81-86
        • Amias AG
        Cerebral vascular disease in pregnancy: 2-occlusion.
        J Obstet Gynecol Br Comm. 1970; 77: 312-325
        • Atkinson EA
        • Fairburn B
        • Heathfield KWG
        Intracranial venous thrombosis as complication of oral contraception.
        Lancet. 1970; I: 914-918
        • Barnett HJM
        • Hyland HH
        Non-infective intracranial venous thrombosis.
        Brain. 1953; 76: 36-49
        • Bots GTAM
        Thrombosis of the galenic system veins in the adult.
        Acta Neuropathol (Berlin). 1971; : 227-233
        • Buchanan DS
        • Brazinsky JH
        Dural sinus and Cerebral venous thrombosis: Incidence in young women receiving oral contraveptives.
        Arch Neurol. 1970; 22: 440-444
        • Estanol B
        • Rodriquez A
        • Conte G
        • Aleman JM
        • Loyo M
        • Puzzuto J
        Intracranial thrombosis in young women.
        Stroke. 1979; 10: 680-684
        • Gettelfinger DM
        • Kokman E
        Superior sagittal sinus thrombosis.
        Arch Neurol. 1977; 34: 2-6
        • Harrison MJG
        • Truelove SC
        Cerebral venous thrombosis as a complication of ulcerative colitis.
        Am J Dig Dis. 1967; 12: 1025-1028
        • Johnson RV
        • Kaplan SR
        • Blailock Z
        Cerebral venous thrombosis in paroxysmal nocturnal hemogloblinuria.
        Neurology. 1970; 20: 681-686
        • Yasargil MG
        • Damur M
        Thrombosis of the cerebral veins and dural sinuses.
        in: Newton TH Pots DG Radiology of the skull and brain. CV Mosby, St. Louis1974: 2376-2400
        • Vines FS
        • Davis DO
        Clinical-radiological correlation in cerebral venous occlusive disease.
        Radiology. 1971; 98: 9-22
        • Carroll JD
        • Leak D
        • Lee HA
        Cerebral thrombophlebitis in pregnancy and the puerperium.
        Q J Med. 1966; 35: 347-368
        • Poltera AA
        The pathology of intracranial venous thrombosis in oral contraception.
        J Pathol. 1972; 106: 209-219
        • Rao KCVG
        • Knipp HC
        • Wagner EJ
        Computed tomographic findings in cerebral sinus and venous thrombosis.
        Radiology. 1981; 140: 391-398
        • Askenasy HM
        • Kosary IZ
        • Braham J
        Thombosis of the longitudinal sinus: diagnosis by carotid angiography.
        Neurology. 1962; 12: 288-292
        • Barnes BD
        • Winestock DP
        Dynamic radionuclide scanning in the diagnosis of thrombosis of the superior sagittal sinus.
        Neurology. 1977; 27: 656-661
        • Buonanno FS
        • Moody DM
        • Ball MR
        • Cowan RJ
        • Laster DW
        • Ball JD
        Radionuclide sinography: diagnosis of lateral sinus thrombosis by dynamic and static brain imaging.
        Radiology. 1979; 130: 207-213
        • Kingsley DPE
        • Kendal BE
        • Moseley IF
        Superior sagittal sinus thrombosis: an evaluation of changes demonstrated on computed tomography.
        J Neurol Neurosurg Psychiatry. 1978; 41: 1065-1068
        • Wendling LR
        Intracranial venous sinus thrombosis: diagnosis suggested by computed tomography.
        Am J Roentgenol. 1978; 130: 978-980
        • Williamson BRJ
        • Teates CD
        • Bray ST
        • Riddervold HO
        • Lees RF
        • Wakefield JA
        Radionuclide brain scan findings in superior sagittal sinus thrombosis.
        Clin Nucl Med. 1978; 3: 184-187
        • Fairburn B
        Intracranial venous thrombosis complicating oral contraception: treatment by anticoagulant drugs.
        Br Med J. 1973; 2: 647
        • Borda IT
        • Southern RF
        • Brown WF
        Cerebral venous thrombosis in ulcerative colitis.
        Gastroenterology. 1973; 64: 116-119
        • Mickle JP
        • McLennan JE
        • Chi JG
        • Lidden CW
        Cortical vein thrombosis in Wegener's granulomatosis.
        J Neurosurg. 1977; 46: 248-251
        • Yerby MS
        Superior sagittal sinus thrombosis 10 years after surgery for ulcerative colitis.
        Stroke. 1980; 11: 294-296
        • Brismar J
        Computer tomography in superior sagittal sinus thrombosis.
        Acta Radiol [Diagn] (Stockh). 1980; 21: 321-326
        • Bick RL
        Alterations of hemostasis associated with malignancy.
        in: 3rd ed. Semin Thromb Hemostatis. 5. 1978: 1-26
        • Davis RB
        • Theologides A
        • Kennedy BJ
        Comparative studies of blood coagulation and platelet aggregation in patients with cancer and non-malignant disease.
        Ann Intern Med. 1969; 71: 67-80
        • Kempin S
        Disorders of hemostasis in malignancy.
        Curr Prob Cancer. 1979; 4: 21-26
        • Reagan TJ
        • Okazaki H
        The thrombotic syndrome associated with carcinoma.
        Arch Neurol. 1974; 31: 390-395
        • Rohner RF
        • Prior JT
        • Sipple JH
        Mucinous malignancies, venous thrombosis and terminal endocarditsis with emboli: a syndrome.
        Cancer. 1966; 19: 1805-1812
        • Sack GH
        • Levin J
        • Bell WR
        Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms.
        Medicine (Baltimore). 1977; 56: 1-37
        • Sproul EE
        Carcinoma and venous thrombosis: the frequency of association of carcinoma in the body or tail of the pancreas with multiple venous thrombosis.
        Am J Cancer. 1938; 34: 566-585
        • Lieberman JS
        • Borrero J
        • Urdaneta E
        • Wright IS
        Thromboembolism associated with neoplasm—review of seventy-seven cases (abstr).
        Circulation. 1960; 22: 780
        • Miller SP
        • Sanchez-Avalos J
        • Stefanski T
        • Zuckerman L
        Coagulation disorders in cancer I. Clinical and laboratory studies.
        Cancer. 1967; 20: 1452-1465
        • Alonso KB
        Detection of prethrombotic and thrombotic states.
        J Clin Lab Sci. 1979; 9: 338-342
        • Weick JK
        Intravascular coagulation in cancer.
        in: 3rd ed. Semin Oncol. 5. 1978: 203-211
        • Pineo GF
        • Brain MC
        • Gallus AS
        • Hirsh H
        • Hatton MWC
        • Regoeczi E
        Tumors, mucus production and hypercoagulability.
        Ann NY Acad Sci. 1974; 230: 262-270
        • Slichter SJ
        • Harker LA
        Hemostasis in malignancy.
        Ann NY Acad Sci. 1974; 230: 252-261
        • Soon BCF
        • Miller SP
        Coagulation disorders in cancer. III. Fibrinolysis and inhibitors.
        Cancer. 1970; 25: 867-874
        • Kasimis BS
        • Spiers ASD
        Thrombotic complications in patients with advanced prostatic cancer treated with chemotherapy.
        Lancet. 1979; I: 159
        • Nevasaari K
        Tamoxifen and thrombosis.
        Lancet. 1978; II: 946-948
        • Gerritis WBJ
        • Prakke EM
        • Van Der Meer
        • et al.
        Corticosteroids and experimental intravascular coagulation.
        Scand J Haematol. 1974; 13: 5-10
        • Isacson S
        Effect of prednisolone on the coagulation and fibrinolytic systems.
        Scand J Haematol. 1970; 7: 212-216
        • Deutsch E
        • Fischer M
        • Frischauf H
        • et al.
        Blood coagulation changes under L-asparaginase therapy.
        in: 3rd ed. Recent results in cancer research. 33. Springer-Verlag, New York1970: 331-341
        • Ramsey NKC
        • Coccia PF
        • Krivit W
        • Nesbit ME
        • Edson JR
        The effect of L-asparaginase on plasma coagulation factors in acute lymphoblastic leukemia.
        Cancer. 1977; 40: 1398
        • Cairo MS
        • Lazarus K
        • Gilmore RL
        • Baehner RL
        Intracranial hemorrhage and focal seizures secondary to use of Lasparaginase during induction therapy of acute lymphocytic leukemia.
        J Pediatr. 1980; 97: 829-833