Congested, Cyanotic Tongue in Patient with Cerebral Venous Thrombosis

Cerebral venous thrombosis may develop in patients with hematologic cancer or solid tumors and can cause direct compression of vessels. Prothrombotic mutations in cancer patients play an important role in venous thrombosis. Patients with cerebral venous thrombosis may present with various symptoms. We report on a 43 year-old woman with nasopharyngeal cancer who developed cerebral venous thrombosis. She presented with seizures and the atypical sign of a thickened, cyanotic tongue. She received concurrent chemotherapy and radiotherapy (CCRT) for nasopharyngeal cancer prior to admission. Computed tomography of the brain, revealed a thrombus at the confluence of the superior sagittal sinus. The right transverse and sigmoid sinuses were also involved. The patient also had a right side hemicranial headache, vomiting and hyperesthesia in her congested, cyanotic tongue. The patient was treated initially with intravenous heparin and her symptoms improved 10 days after. Occlusion of venous sinuses remained after treatment but the patient was symptom free.