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Table of Contents    
NEUROIMAGES
Year : 2017  |  Volume : 65  |  Issue : 2  |  Page : 425

Vein of Trolard thrombosis


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 Publication10-Mar-2017

Correspondence Address:
Li Yang
Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, Hunan - 410011
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/neuroindia.NI_670_16

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How to cite this article:
Yang M, Yum S, Yang L. Vein of Trolard thrombosis. Neurol India 2017;65:425

How to cite this URL:
Yang M, Yum S, Yang L. Vein of Trolard thrombosis. Neurol India [serial online] 2017 [cited 2017 Aug 24];65:425. Available from: http://www.neurologyindia.com/text.asp?2017/65/2/425/201867


Sir,

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].[1] The patient underwent superior sagittal sinus clot retrieval, with significant clot removal [Figure 2];[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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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Stam J. Thrombosis of the cerebral veins and sinuses. N Eng J Med 2005;352:1791-8.  Back to cited text no. 1
    
2.
Khan SH, Adeoye O, Abruzzo TA, Shutter LA, Ringer AJ. Intracranial dural sinus thrombosis: Novel use of a mechanical thrombectomy catheter and review of management strategies. Clin Med Res 2009;7:157-65.  Back to cited text no. 2
    


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