title: Thrombosis of the great cerebral vein in a hemodialysis patient.
abstract: Cerebral venous thrombosis is a rare condition with various clinical presentations which may delay diagnosis. It is frequently associated with severe consequences. We present the first documented case of thrombosis of the great cerebral vein in a hemodialysis patient. A 29-year-old female patient with end-stage renal disease of unknown etiology was admitted to a hospital with altered consciousness and nausea. Severe headache in the right parietal area had started 2 days before. On examination, she was in the poor overall condition, dysartric, with a severe nystagmus. Urgent brain multislice computerized tomography and magnetic resonance imaging revealed thrombosis of the great cerebral vein with hypodense zones in hypothalamus, thalamus and basal ganglia. She was treated with heparin bolus of 25000 IU with a favorable outcome. Detailed examination demonstrated increased lupus anticoagulant (LA) 1 and LA2 and increased LA1/LA2. Control magnetic resonance imaging performed 1 year later revealed multiple vascular lesions within the brain. Acetylsalicylate was introduced in therapy. Thrombosis of the cerebral veins should be suspected in patients with end-stage renal disease, altered neurological status and signs of increased intracranial pressure.
authors.affiliation: Department of Nephrology and Haemodialysis, Clinical Centre Montenegro, Podgorica, Montenegro.
authors.forename: Marina
authors.initials: M
authors.lastname: Ratkovic
authors.forename: Nikolina
authors.initials: N
authors.lastname: Basic-Jukic
authors.forename: Branka
authors.initials: B
authors.lastname: Gledovic
authors.forename: Danilo
authors.initials: D
authors.lastname: Radunovic
mesh_terms: D000328:Adult; D001241:Aspirin / Q000008:administration & dosage*; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007427:Intracranial Pressure; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D018810:Magnetic Resonance Angiography; D009759:Nystagmus, Pathologic / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D011859:Radiography; D006435:Renal Dialysis; D020246:Venous Thrombosis / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology
chemical_list: D005343:Fibrinolytic Agents; D016682:Lupus Coagulation Inhibitor; D001241:Aspirin
keywords: End-stage renal disease; great cerebral vein; thrombosis