Superior sagittal sinus thrombosis induced by thyrotoxicosis - Case report

There is a wide variety of disorders associated with thrombosis of the supe rior sagittal sinus (SSS), including infectious disease, noninfectious cond itions such as vasculitis and hypercoagulable states, and complications ari sing from pregnancy or use of oral contraceptive medications. Despite these well-defined associations, approximately 25% of the cases remain idiopathi c. In this article the authors describe a patient who was found to have SSS thrombosis while experiencing a thyrotoxic phase of Graves disease. The pa tient presented with intracerebral hemorrhage, subarnchnoid hemorrhage, sei zure, coma, a raised fibrinogen concentration,low protein C activity, and a trial fibrillations. Thrombolysis was successfully performed despite the co existence of thrombosis and intracranial hemorrhage. Patients with thyrotox icosis and a diffuse goiter may be predisposed to the development of SSS th rombosis, as a result of hypercoagulation and stasis of local venous blood flow. In the present ease, a patient in whom thrombosis coexisted with intr caranial hemorrhage was successfully treated using thrombolytic therapy.