Transient Ischemic Attack-Like Presentation of Extensive Cerebral Venous Thrombosis in a Child With Anaplastic Large Cell Lymphoma

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Cerebral venous sinus thrombosis (CVST) is a rare but serious cerebrovascular complication in children, particularly in the setting of malignancy. We report a case of a 12-year-old boy with anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma who developed extensive CVST shortly after initiation of chemotherapy. He presented with a transient neurological episode characterized by limb heaviness and dysarthria, initially suggestive of a transient ischemic attack, with complete spontaneous recovery. Although the clinical context raised concern for treatment-related complications, neuroimaging was essential for diagnosis, and magnetic resonance venography confirmed extensive CVST. The patient was treated with anticoagulation using low-molecular-weight heparin, followed by rivaroxaban, with continuation of chemotherapy under close monitoring. Clinical and radiological outcomes were favorable, with complete recanalization after nine months and no neurological sequelae. This case underscores the importance of early recognition of CVST in pediatric oncology patients with atypical neurological symptoms and the pivotal role of prompt neuroimaging.