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|Year : 2017 | Volume
| Issue : 2 | Page : 425
Vein of Trolard thrombosis
Mo Yang1, Sabrina Yum2, Li Yang1
1 Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
2 Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, Commonwealth of Pennsylvania, USA
|Date of Web Publication||10-Mar-2017|
Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, Hunan - 410011
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Yang M, Yum S, Yang L. Vein of Trolard thrombosis. Neurol India 2017;65:425
A 40-year-old woman undergoing in-vitro fertilization (IVF) with estrogen therapy presented with subacute onset difficulty in speaking and increasing right-sided weakness. In the emergency department, the symptoms worsened and she had a generalized seizure. Computed tomography of the head revealed intraparenchymal hemorrhage and vein of Trolard thrombosis extending into the superior sagittal sinus [Figure 1]. The patient underwent superior sagittal sinus clot retrieval, with significant clot removal [Figure 2]; however, she remained aphasic and right hemiplegic at 3 months. Of note, she had an episode of right-sided weakness and aphasia when on oral contraceptive pills 3 years ago that resolved spontaneously after stopping the pill. Hence, patients undergoing IVF are at risk for cerebral venous thrombosis including the vein of Trolard thrombosis. Appropriate screening with a good history is necessary in these patients before instituting therapy.
|Figure 1: CT scan revealed a left temporoparietal hematoma (a) with a high density cerebral vein (b). CT venogram demonstrated a thrombus in left vein of Trolard, extending into the superior sagittal sinus (c). Four hours after presentation, a repeat CT scan showed a new hematoma in the left precentral gyrus (d)|
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|Figure 2: Digital subtraction angiography demonstrated thrombosis within the mid-superior sagittal sinus (a,c). Mechanical thrombectomy was performed with improved antegrade flow and decreased clot burden in the superior sagittal sinus (b,d)|
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[Figure 1], [Figure 2]