Venous sinus thrombosis leading to stroke in a patient with sickle cell disease on hydroxyurea and high hemoglobin levels: treatment with thrombolysis

Am J Hematol. 2008 Oct;83(10):818-20. doi: 10.1002/ajh.21261.

Abstract

A 21-year-old man with homozygous sickle cell disease maintained on hydroxyurea for 1 year developed thrombosis of the superior sagittal, right transverse, and right sigmoid dural sinuses with a large venous infarct. He was successfully treated with endovascular thrombolysis. Investigation did not reveal any inherited or acquired hypercoagulable state. This patient however had consistently elevated hemoglobin levels both at the time of the initial event and on follow up. One year later he developed symptomatic avascular necrosis of the right hip. High hemoglobin levels resulting from hydroxyurea therapy may have contributed to development of complications in this patient.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Sickle Cell / drug therapy*
  • Anemia, Sickle Cell / genetics
  • Antisickling Agents / therapeutic use*
  • Brain Infarction / diagnostic imaging
  • Dura Mater / blood supply
  • Follow-Up Studies
  • Hemoglobins / analysis*
  • Hip / diagnostic imaging
  • Hip / pathology
  • Homozygote
  • Humans
  • Hydroxyurea / therapeutic use*
  • Male
  • Osteonecrosis / complications
  • Osteonecrosis / diagnostic imaging
  • Osteonecrosis / pathology
  • Radiography
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / drug therapy
  • Stroke* / drug therapy
  • Stroke* / etiology
  • Thrombolytic Therapy*
  • Time Factors
  • Treatment Outcome

Substances

  • Antisickling Agents
  • Hemoglobins
  • Hydroxyurea