Cranial sinus thrombosis associated with essential thrombocythemia followed by heparin-associated thrombocytopenia

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Abstract
Both bleeding and thrombosis are complications of essential thrombocythemia (ET). Common sites of thrombosis are cardiac and cerebral arteries. Mesenteric veins or deep leg veins are less often affected. [1] Cranial sinus thrombosis is a rare manifestation of the disease. [2] We report such a case in a patient who, in addition, developed heparin-associated thrombocytopenia (HAT) during IV heparin therapy. ### Case report. A 52-year-old woman presented with a several day history of headache, nausea, and vomiting. In addition, she complained of tingling in her left arm and intermittent involuntary movements in her left hand, consistent with focal epileptic seizures, and impaired cognitive function. She had been on estrogens several months before onset of her symptoms and took no other medication. On examination, she had slight left hand weakness and moderate splenomegaly. Magnetic resonance flow imaging showed thrombosis of both the right transverse and the superior sagittal sinus. Abnormal laboratory values revealed a white blood count showing slight …

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