Cerebral venous sinus thrombosis complicated with haemorrhagic venous infarction and seizures, successfully treated with oral anticoagulation for one year: a case report

A 43-year-old mother of two children presented with an episode of cerebral venous sinus thrombosis (CVST) complicated with haemorrhagic venous infarction and seizure. She had two first trimester miscarriages and was on combined oral contraceptive pills (COCP) for two months. Computed tomography (CT) venogram revealed venous sinus thrombosis with a right partial lobe haemorrhagic infarction. She was treated with subcutaneous enoxaparin for 14-days followed by oral warfarin for one year. The patient was started on oral levetiracetam but gradually tailed off over four months. Physiotherapy and occupational therapy were continued. She was advised on non-hormonal family planning methods. Thrombophilia and autoimmune screening were negative. Haemorrhagic venous infarction complicated with seizures is a rare manifestation of venous sinus thrombosis. Timely and personalized anticoagulation is the mainstay of treatment.