A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma Case report

Rationale: Deep cerebral venous thrombosis (DCVT) is a rare disease, but always results in poor prognosis. Patient concerns: We reported a 79-year-old female with coma after traumatic brain injury (TBI). Diagnosis: The epidural hematoma was first diagnosed on non-contrast computerized tomography (CT). The hypodense areas in bilateral thalami and basal ganglia on reexamination CT highly indicated the suspicion of DCVT. Finally, the appearance of thrombosis of the vein of Galen on the computed tomography venography (CTA) and digital subtraction angiography (DSA) confirmed the diagnosis. Interventions: The patients received surgery to remove the epidural hematoma. After that, she was treated with oral anticoagulation agent (low molecular weight heparin (LMWH), 180 Axal U/kg 24h) for 4 weeks, shifted by oral warfarin (2.5 mg qd) for 4 weeks. Outcomes: The hypodense areas in bilateral thalami and basal ganglia have been largely reversed. At the time of 6 months after surgery, the patient could take care of herself. Lessons: If the CT shows hypodense areas in bilateral thalami and basal ganglia, a diagnosis of DCVT should be suspected once the patients could not recover from the treatment of primary diseases.