Cerebral venous sinus thrombosis and aneurysm in a patient with double heterozygous beta-thalassemia major: A case report

RATIONALE: Thalassemia is an inherited disease associated with thromboembolic events (TEE) and cerebral artery disease. Here, we report a patient with beta-thalassemia presenting with intracerebral hemorrhage due to cerebral venous sinus thrombosis (CVST), and intracranial aneurysms were found after examination. We believe that it is very rare for this patient to have two kinds of cerebrovascular diseases. PATIENTS’CONCERN: A 25-year-old woman suffered from headache for nine days. She had a history of thalassemia and splenectomy nine years prior. DIAGNOSIS: Intracranial hemorrhage, Cerebral venous sinus thrombosis, Intracranial aneurysm and double heterozygous beta-thalassemia major. INTERVENTIONS: The patient was treated with low-molecular-weight heparin sodium injection (4100IU sc q12 h) and then switched to warfarin after four days of overlap with low-molecular-weight heparin sodium injection. Oral hydroxyurea was prescribed before discharged from the hospital. OUTCOMES: The patient's headache was relieved significantly within 48 h, and re-examination of CT showed that the hemorrhage was completely absorbed one week later. LESSONS: CVST and intracranial aneurysms are associated with the pathological mechanism of thalassemia, and patients with beta-thalassemia should be monitored and educated for long-term prevention, especially those with risk factors.