Cerebral sinus thrombosis associated with iron deficiency anemia in adults-a report of three cases

Abstract

We report three rare cases of cerebral sinus thrombosis (CST) associated with iron deficiency anemia (IDA) in adults. Case 1: A 34-year-old female presented with unconsciousness and status epileptics because of thrombosis of the superior sagittal sinus. After administration of unfractionated heparin in the acute phase followed by warfarin, she was discharged uneventfully. She had IDA due to untreated myoma uteri. After resection of the myoma and discontinuation of warfarin, no recurrence of CST was reported for four years. Case 2: A 38-year-old female was admitted because of headache and unconsciousness due to hemorrhagic infarction of the right temporal lobe and ipsilateral thrombosis of the transverse-sigmoid sinus. Hypermenorrhea was found to be the cause of IDA. After heparin and warfarin therapy, she was discharged with left hemianopsia. Case 3: A 51-year-old female presented with headache and unconsciousness because of hemorrhagic infarction of the left temporal lobe and ipsilateral thrombosis of the transverse-sigmoid sinus. The thrombosis was ascribed to the simultaneous use of estrogen derivatives and IDA due to myoma uteri. After heparin and warfarin therapy, she was discharged with mild cognitive impairment and sensory aphasia. We should be aware that CST is occasionally associated with IDA.