Case Report
Cerebral Venous Thrombosis Associated With Iron Deficiency Anemia

https://doi.org/10.1016/j.jstrokecerebrovasdis.2008.04.008Get rights and content

A 55-year-old man presented with generalized seizures and postictal left hemiparesis. Computed tomography scanning of his head showed a low density area in the right frontal lobe. Cerebral angiography demonstrated a partial defect in the superior sagittal sinus and cortical veins, indicating the presence of cerebral venous thrombosis. He had bleeding from a peptic ulcer and the laboratory data revealed iron deficiency anemia concomitant with an elevation of D-dimer and thrombin-antithrombin III complex (TAT). After the anemia resolved with the treatment of the peptic ulcer and iron supplementation, the TAT and D-dimer levels were normalized, and the occluded veins were recanalized. In a cerebral venous thrombosis associated with iron deficiency anemia, treatment for the anemia may improve hypercoagulable state without antithrombotic therapy, although the long-term monitoring of TAT and D-dimer levels is required.

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Discussion

A variety of diseases and conditions appear to cause CVT.1, 2, 3 Despite extensive investigations, the origin remains unknown in up to 35% of CVT cases.1 In the current case, causes or risk factors of CVT such as head trauma, coagulation disorder, infection, autoimmune disorders including angiitis and Behçet's disease, and malignancy were not detected. Iron deficiency anemia has been suggested to be associated with stroke, although it is still difficult to provide direct evidence.4, 5, 6, 7, 8

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