Department of Surgery and Cancer, Imperial College London, London, UK
ENT Department, Imperial College Healthcare NHS Trust, London, UK.
BMJ Case Rep. 2020 Jun 1;13(6):e235240. doi: 10.1136/bcr-2020-235240.
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.
尽管有充分的文献记载表明癌症患者和化疗期间的血栓形成风险增加，但脑静脉窦血栓形成（CVT）仍然很少见。我们报告了一例罕见的因左横窦血栓形成导致的脑脊液（CSF）鼻漏病例，该病例发生在 2 年前乳腺癌化疗期间。患者接受了三层修复，使用了 Neuro-Patch、鼻中隔软骨和中鼻甲蒂瓣，并开始服用乙酰唑胺。1 年随访时无复发。颅内压升高继发于脑静脉闭塞可侵蚀颅底并易导致 CSF 漏。尽管存在理论风险，但尚未有报道称化疗诱导的 CVT 后发生 CSF 漏。我们描述了首例病例，并讨论了其病理生理学和治疗方法。
