Factor Xa inhibitor for the treatment of cerebral venous thrombosis in a patient with hyperthyroidism

Abstract

We report a case of a 49-year-old woman admitted for headache, confusion, and right hemiparesis. Computed tomography showed a small subcortical hemorrhage in the left frontal lobe. Cerebral angiography revealed a superior sagittal sinus thrombosis. She was treated with unfractionated heparin. Follow-up imaging revealed bilateral cerebellar infarcts and a small cerebellar hemorrhage. On day 12 in hospital, she was switched from heparin to rivaroxaban. Her symptoms significantly improved, and after 3 weeks of the therapy, magnetic resonance venography showed complete recanalization of the superior sagittal sinus. Rivaroxaban might be a better option for the treatment of cerebral venous thrombosis.