Superior sagittal sinus thrombosis and bilateral transverse sinus thrombosis: case report

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    An event is serious (based on the ICH definition) when the patient outcome is:

    • * death

    • * life-threatening

    • * hospitalisation

    • * disability

    • * congenital anomaly

    • * other medically important event

    “ ”

    In a single-centre retrospective study of 3 patients with COVID-19 admitted at an academic hospital in USA (study period: 1 March 2020 to 9 August 2020), a 25-year-old woman was described, who developed superior sagittal sinus thrombosis and bilateral transverse sinus thrombosis during treatment with avatrombopag for idiopathic thrombocytopenic purpura (ITP).

    The woman, who had Evans Syndrome for 8 years and von-Willebrand disease and a history of multiple intracerebral haemorrhages, was receiving avatrombopag [route and dosage not stated] for ITP. Subsequently, she presented with complaints of intractable headache, blurry vision and tingling of the right upper extremity. She had been diagnosed with COVID-19 infection 4 months prior, but was negative upon repeat testing. On presentation, MR venogram showed superior sagittal sinus thrombosis and bilateral transverse sinus thrombosis [duration of treatment to reactions onsets not stated], suspected to be secondary to avatrombopag. Additionally, COVID-19 infection was considered as a risk factor.

    Thus, the woman started receiving heparin [unfractionated heparin] and was transitioned to apixaban. Her avatrombopag therapy was switched to fostamatinib for its lower risk of prothrombotic events [outcomes not stated].


    1. Nwajei F, et al. Cerebral Venous Sinus Thromboses in Patients with SARS-CoV-2 Infection: Three Cases and a Review of the Literature. Journal of Stroke and Cerebrovascular Diseases 29: No. 12, Dec 2020. Available from: URL: http://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105412

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    Avatrombopag. Reactions Weekly 1838, 88 (2021). https://doi.org/10.1007/s40278-021-89407-7

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