Cerebral Venous Thrombosis due to Heparin-Induced Thrombocytopenia in a 17- Year Old Female Trauma Patient: Successful Treatment with Fondaparinux

Thrombosis of cerebral veins and sinuses (CVST) is a rare condition seldom affecting young adults and children. The development of cerebral sinus thrombosis as a complication of heparin-induced thrombocytopenia/thrombosis syndrome (HIT/HITT) is even rarer. We describe a case of a 17-year old female with multiple fractures, who developed CVST secondary to HIT, while being under thromboprophylaxis with low molecular weight heparin (LMWH). The patient was successfully treated afterwards with 7.5 mg fondaparinux once daily subcutaneously. Our patient’s outcome was excellent, without recurrent thrombotic or bleeding events throughout her therapy. Fondaparinux is a synthetic pentasaccharide selectively inhibiting activated factor X. Published data have shown that due to its short structure, the drug almost never causes clinical HIT/HITT, therefore it could be a useful alternative anticoagulant agent for treating HIT/HITT patients.