A rare complication in a child undergoing chemotherapy for acute lymphoblastic leukemia: Superior sagittal sinus thrombosis

作者：Wang Ting Yao; Yen Hsiu Ju^*; Hung Giun Yi; Hsieh Ming Yun; Tang Ren Bin

来源：Journal of the Chinese Medical Association, 2011, 74(4): 183-187.

DOI：10.1016/j.jcma.2011.01.041

• Acute lymphoblastic leukemia
• L-Asparaginase
• Superior sagittal sinus thrombosis

We report the case of a 4-year-old boy with acute lymphoblastic leukemia in high-risk group who suffered from generalized tonic-colonic seizure evolving into status epilepticus, and subsequent left hemiparesis during his first reinduction chemotherapy, consisting of dexamethasone, vincristine, L-asparaginase, and epirubicin. Superior sagittal sinus and cerebral venous thrombosis, predominantly in right side, were proved by brain magnetic resonance imaging. After aggressive treatment with low-molecular weight heparin (LMWH), left hemiparesis improved in I week. And he was fully ambulatory 3 weeks later. The second cycle of reinduction chemotherapy was conducted smoothly with the concomitant: use of LMWH This case illustrates the strong correlation of the rare thrombotic complication, superior sagittal sinus thrombosis, and hyperccagulable status secondary to combination use of L-asparaginase and corticosteroid. Early and vigilant recognition of superior sagittal sinus thrombosis and prompt anticoagulation with LMWH may prevent further neurological damage.

• 出版日期2011-4