Introduction: Early diagnosis of cerebral vein thrombosis (CVT) is crucial to prevent complications such as hydrocephalus, intracranial hypertension, and epilepsy. On the other hand, chronic subdural hematoma (SDH) is a bleeding collected between the inner layer of the dura mater and the arachnoid of the meninges surrounding the brain. Association between these conditions leads to a controversy, as anticoagulation which is mandatory during the first situation, leads to a worsening of the second.
Case report: We report the case of a 70-year-old man with a medical background of pulmonary tuberculosis, who presented with a progressive deterioration of his neurological status. Physical examination showed a GCS of 13/15, without any signs of localisation. Brain CT scan showed a thrombosis of the left lateral sinus. The decision was to introduce anticoagulation. Few days after, the patient presented a transitory improvement, followed by a worsening. Another CT scan was performed, which showed an hemispheric subdural hematoma without important mass effect. The decision was to maintain anticoagulation under narrow supervision. A control CT scan showed a regression of both hematoma and thrombosis.
Conclusion: Our reported case adds to the limited literature on Indications of anticoagulant treatment in the association of cerebral vein thrombosis and subdural hematoma. We should be aware of the limitations of anticoagulant treatment whose maintain preserves the hope for the most total possible recovery.
