Cerebral Venous Sinus Thrombosis Related to Iron-Deficiency Anemia

Cerebral venous sinus thrombosis (CVST) is an uncommon diagnosis associated with life-threatening and long-term neurological consequences in children. It is characterized by non-specific symptoms, including fever, altered mental status and focal neurological deficits. Etiologic factors include infection, trauma, prothrombotic disorders and importantly, iron-deficiency anemia. Iron-deficiency anemia is a preventable risk factor of CVST as it is commonly caused by excessive cow milk consumption in infants and toddlers. Diagnosis is mainly made with MRI and magnetic resonance venography (MRV). Prompt anticoagulation is a key therapeutic intervention, and in the case of associated iron deficiency, iron repletion and elimination or limitation of milk from diet are also required. Thus, it is essential for physicians to have a high level of suspicion to diagnose CVST, given its non-specific presentation. This is a case report of a two-year-old boy who presented to the pediatric emergency department with vomiting and altered mental status and was ultimately diagnosed with CVST.