Successful management of cerebral venous sinus thrombosis due to adenomyosis: Case reports and literature review.

Bingyu Li, Kening Shi, Chenxi Jing, Lijuan Xu, Min Kong, Maowen Ba

Journal: Clinical neurology and neurosurgery 2023;229():107726

PMID: 37094498

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

Cerebral venous sinus thrombosis (CVST) due to adenomyosis, though rare, threaten women with severe morbidity. Adenomyosis is easily overlooked in the etiological assessment of CVST. Etiological under-recognization has considerable prognostic, and therapeutic implications. The current study reports two cases of successful management of cerebral venous sinus thrombosis due to adenomyosis.

MATERIALS AND METHODS

We present two young women with cerebral venous sinus thrombosis due to adenomyosis. We additionally review the literature to identify previously reported cases of stroke associated with adenomyosis.

RESULTS

Except for this report, a total of 25 cases of stroke related to adenomyosis have been reported in the literature, of which only three cases are related to CVST. Through their diagnosis and treatment, we believe that early diagnosis and treatment are important for these patients with long-term illnesses. In addition, through literature review, for female stroke patients with heavy menstruation combined with anemia or carbohydrate antigen (CA) 125 elevation, the existence of adenomyosis should be vigilant and the etiological treatment should be timely targeted.

CONCLUSION

Our cases illustrate the significance of the etiological identification of CVST for women with adenomyosis and serve to increase clinicians' awareness of this disabling, but sometimes treatable, condition. In CVST due to adenomyosis associated with iron deficiency anemia and/or high serum CA125 level, antithrombotic therapy and treatment for the anemia may improve the hypercoagulable state. The long-term monitoring of D-dimer levels is required.

Address: Department of Neurology, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, China.; Department of Neurology, Yantaishan Hospital, Yantai, Shandong 264000, China. Electronic address: [email protected].; Department of Neurology, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, China; Yantai Regional Sub center of National Center for clinical Medical Research of Neurological Diseases, China. Electronic address: [email protected].

DOI: 10.1016/j.clineuro.2023.107726