Abstract
Tamoxifen, one of the most commonly used selective estrogen receptor modulators for breast cancer, can lead to thromboembolic complications. Cerebral venous sinus thrombosis (CVST) is an uncommon type of stroke that can lead to infarction and hemorrhage, requiring careful attention for accurate diagnosis and treatment. Here, we report a case of CVST that occurred during breast cancer treatment. A 48-year-old woman with breast cancer had been treated with tamoxifen for 5 years. She visited a local hospital with a complaint of a headache, but computed tomography (CT) did not reveal the underlying cause. A day later, she was transferred to our hospital because of an aggravated headache and sensory aphasia. CT showed subcortical hematoma in the left temporal and occipital lobe. CVST was suspected but could not be diagnosed, and she was admitted for careful observation without any anticoagulation or intervention. The day after her hospitalization, her aphasia got worse, and there was also an increase in the D-dimer level (15.9 µg/ml). Angiography disclosed superior sagittal sinus occlusion and pseudophlebitic pattern, leading to the diagnosis of superior sagittal sinus thrombosis. She underwent transvenous thrombectomy by aspiration catheter and stent retriever, leading to recanalization and significant improvement in symptoms.
