Unilateral Postoperative Deep Cerebral Venous Thrombosis with Complete Recovery: A Report of 2 Cases.
Postsurgical deep brain venous thrombosis has not been well described in children before. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the internal cerebral veins (ICVs) and the vein of Galen. However, even when they are well preserved during surgery, postoperative hemodynamic changes, mainly in the first 24 h, or surgical manipulation can cause thrombosis of these veins. We report 2 children with unilateral postoperative ICV thrombosis; in 1 of the patients the vein of Galen was also thrombosed. Although both patients had altered sensorium initially, no anticoagulation therapy was given, and they both recovered well. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the ICV and the vein of Galen. The surgeon should respect the deep brain venous system when approaching midline structures. Both the neurosurgeon and the neuroradiologist should be aware of this possible complication in order to make a prompt diagnosis and to offer proper treatment if needed.
Divisions of Neurosurgery, Neuroradiology, and Neurooncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Mony
M
Benifla
Suzzanne
S
Laughlin
Zulma S
ZS
Tovar-Spinoza
James T
JT
Rutka
Peter B
PB
Dirks
D000293:Adolescent; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D002551:Cerebral Ventricle Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D002648:Child; D005910:Glioma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods; D011184:Postoperative Period; D013788:Thalamus / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging
Internal cerebral vein; Pediatric neurosurgery; Postoperative deep brain venous thrombosis; Thrombosis; Vein of Galen