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Case report
Chemotherapy associated dural sinus thrombosis presenting as a cerebrospinal fluid leak
  1. Iulia Bujoreanu1,
  2. Mark Ferguson2 and
  3. Hesham Saleh2
  1. 1Department of Surgery and Cancer, Imperial College London, London, UK
  2. 2ENT Department, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Iulia Bujoreanu; ibujoreanu01{at}gmail.com

Abstract

Despite the well documented increased risk of thrombosis in patients with cancer and during chemotherapy, cerebral venous sinus thrombosis (CVT) remains a rare entity. We present a rare case of cerebrospinal fluid (CSF) rhinorrhoea secondary to a left transverse sinus thrombus which occurred 2 years previously during chemotherapy for breast cancer. The patient underwent a three-layer repair using Neuro-Patch, septal cartilage and middle turbinate pedicle flap and was started on acetazolamide. There was no recurrence at 1-year follow-up. Raised intracranial pressure secondary to cerebral venous occlusion can erode the base of skull and predispose to CSF leaks. Despite the theoretical risk, there have been no cases reported where CSF leaks have occurred following chemotherapy induced CVT. We describe the first case and discuss pathophysiology and management.

  • chemotherapy
  • venous thromboembolism
  • coma and raised intracranial pressure

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Footnotes

  • Contributors All authors contributed equally to the article. IB: drafting of paper, literature review. MF: revision of paper, concept. HS: revision of paper, concept.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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