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Deep Coma Due to Severe Multiple Sinus Thromboses Rescued by Intravenous Heparin and Pulse Steroid

Background: Sinus thrombosis is readily diagnosed with either brain CT venogram or MRI venogram. However, diagnosis can be challenging particularly in comatose patients. Deep cerebral vein thrombosis can be life threatening if not diagnosed and treated at onset. Treatment has risk of hemorrhagic complication, yet the only indication of anticoagulation in the presence of hemorrhagic stroke is cerebral sinus thrombosis.
Method: We report a 62-year-old lady presented in deep coma due to severe multiple dural sinuses and deep cerebral vein thrombosis. Treated with intravenous heparin and pulse steroid, she completely recovered cognitive and motor functions. She maintained her function eight years later.
To the best of our knowledge this is the first case in the literature with severe multiple sinus thrombosis successfully treated with heparin and high dose IV steroids.
Conclusion: Early, diagnosis and treatment of deep cerebral vein thrombosis even if the patient is comatose, gives real chance of recovery.


Hassan Ali Alayafi, Mukki Almuntashri and Hussain Jawad

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