Simone Magnisio*, Oonagh Sheehy
Department of Hematology, Belfast City Hospital, UKFulltext PDF
A 69-year-old woman was recently diagnosed with DLBCL within the Haematology department. Her diagnosis was discussed at MDM and decision to start chemotherapy was made. After the usual pre-chemo investigations, she developed a new parieto-occipital headache. She underwent a CT brain, which showed a filling defect in the right transverse sinus suspicious for venous sinus thrombosis. While waiting for an MRI, she started treatment with low molecular weight heparin. A subsequent MRI brain confirmed an 8 mm well defined filling defect in the right transverse sinus in keeping with an arachnoid granulation. Therefore, heparin was stopped; patient received supportive treatment and subsequently started chemotherapy. The aim of this report is to illustrate the importance of a differential diagnosis in the context of sudden onset headache and CT findings suspicious of venous thrombosis. Avoiding anticoagulation therapy when not needed and considering MRI brain as soon as possible are key steps to take into account especially in frail haematological patients.
Magnisio S, Sheehy O. Importance of Differential Diagnosis in Suspected Venous Sinus Thrombosis: Arachnoid Granulation. Clin Surg. 2020; 5: 2793..