Fatal dural sinus thrombosis associated with heterozygous factor V Leiden and a short activated partial thromboplastin time.

Abstract

Inherited thrombophilia is a risk factor for dural sinus thrombosis (DST). To our knowledge, this is the first description with autopsy findings of a patient with DST associated with heterozygous factor V Leiden and a short activated partial thromboplastin time (aPTT). A 51-year-old woman presented with a 3-day history of headache, nausea, right-sided weakness, and focal motor seizure; she died 3 days after admission. At autopsy, a gross examination showed hemorrhage of bilateral parietal lobes and left primary motor cortex, uncal and tonsillar herniation, and pulmonary embolus of the right upper lobe. A microscopic examination of the brain showed an organizing thrombus in the superior sagittal sinus, diffuse cerebral edema, and extensive venous congestion. Laboratory studies showed heterozygous factor V Leiden by polymerase chain reaction and a very short aPTT of 17 seconds (reference range, 22-30 seconds). The combination of a heterozygous factor V Leiden mutation and a short aPTT may have contributed to the fatal DST in this patient.

• Authors: Christina L Stephan, Karen SantaCruz, Corrie May, Steve B Wilkinson, Mark T Cunningham
• Journal: Archives of pathology & laboratory medicine (Arch Pathol Lab Med) Vol. 127 Issue 10 Pg. 1359-61 (Oct 2003) ISSN: 1543-2165 [Electronic] United States
• PMID: 14521455 (Publication Type: Case Reports, Journal Article)

Chemical References

• factor V Leiden
• Factor V

Topics

• Factor V (genetics)
• Fatal Outcome
• Female
• Humans
• Magnetic Resonance Imaging
• Middle Aged
• Mutation
• Partial Thromboplastin Time
• Sinus Thrombosis, Intracranial (diagnosis, pathology)