Cerebral Venous Sinus Thrombosis during Chemotherapy with Capecitabine: Case Presentation and Strategy for Anticoagulation.

Abstract Cerebral venous sinus thromboses (CVST) are rare but may be associated to life-threatening prognosis and prolonged disability. We report a case of CVST during chemotherapy with capecitabine in a patient with metastatic breast cancer without any additional risk factors. She presented with headache, depressed consciousness and sensorial aphasia. Several cerebral venous sinuses were involved, with associated deep venous extension, brain infarcts and secondary parenchymal bleeding. Evolution after anticoagulation with heparin during the acute phase and long-term rivaroxaban has been favorable, with full neurologic recovery and absence of thrombotic relapses and bleedings. Furthermore, chemotherapy with capecitabine was restarted and is maintained so far, with a durable response and no additional complications. Keywords: Cerebral venous sinus thrombosis. Breast cancer. Chemotherapy. Capecitabine.