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Background. Patients with hemophilia are protected from thrombosis by a deficiency of one of coagulation factors, therefore thrombotic complications are rare in them. Currently, few descriptions of spontaneous venous thrombosis in adult hemophiliacs can be found in the literature. Even fewer data of thromboembolic complications are reported in pediatric practice. At present, no clear recommendations are given for the management of thrombotic complications in children with hemophilia, which requires further study of this issue to develop prevention and treatment regimens, including otogenic sinus thrombosis in this category of patients.Case description. A 7-year-old boy was transferred from the Somatic Hospital to the Intensive Care Unit of Regional Clinical Hospital No. 2 in Tyumen (Russia) with an Otorhinolaryngology Unit. He was diagnosed with non-perforative form of acute right-sided suppurative otitis media, acute right-sided mastoiditis, thrombosis of the right sigmoid sinus. The anamnesis shows that the child is diagnosed with hemophilia A, of moderate severity (factor VIII level — 5%), for which he has been receiving factor VIII replacement therapy for the last year. Upon admission, a general blood test revealed no abnormalities, with a slight increase in acute-phase parameters: C-reactive protein, fibrinogen, signs of hypocoagulation. Due to negative dynamics, the child underwent anthromastoidotomy against the background of intensive replacement therapy. Surgery revealed the presence of granulation tissue with hemorrhagic thrombi in the antrum and aditus. In the postoperative period, replacement therapy was accompanied with antibacterial and anticoagulant therapy.Conclusion. The management of patients with otogenic sinus thrombosis against the background of hereditary factor VIII deficiency is a difficult task. On the one hand, it requires surgical intervention and anticoagulant therapy in order to prevent further thrombosis, on the other hand — intensive replacement therapy in order to reduce the risks of hemorrhagic complications. The described case demonstrates the need for an interdisciplinary approach to the diagnosis and treatment of a patient with otogenic thrombosis of lateral sinus against the background of hemophilia A. The approach is to minimize the risks of intraoperative complications and insure a favorable outcome.

Cerebral sinus venous thrombosis is a rare neurovascular emergency that frequently occurs in critically ill patients. We reported a case of sinus venous thrombosis in a patient with coronavirus infection. “Cytokine storm” was the main cause of severe COVID-19 with high levels of inflammatory markers found in the blood (leukocytosis, thrombocytopenia, C-reactive protein, D-dimer). Hypercoagulation in the patient was manifested by an increase in D-dimer, an increase in prothrombin time; decrease in INR, fibrinogen, decrease in antithrombin. In the patient, when prescribing anticoagulants, a decrease in D dimer was observed with an improvement in neurological disorders. Dynamic assessment of the level of D-dimer is required throughout the entire period of inpatient treatment. The increase in hepatic transaminases in dynamics, in our opinion, was facilitated by drugs used in the treatment of COVID 19. [ABSTRACT FROM AUTHOR]

This study aims to determine the existing pathways of collateral cerebral circulation in parasagittal meningiomas that cause superior sagittal sinus occlusion based on literature review and analysis of own clinical observations. Results of clinical and instrumental examination of 221 patients treated in Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov from 2000 to 2021 were subjected to retrospective and prospective analysis. Inclusion criteria were:patient age of 18+, parasagittal extracerebral tumor according to computed tomography/magnetic resonance imaging, histologically verified meningioma, superior sagittal sinus occlusion (type V-VI according to M.P. Sindou and J.E. Alvernia) according to selective cerebral angiography. This study is based on the analysis of examination of 43 patients who met the inclusion criteria. The selected patients were analyzed for demography (sex, age), brain computed tomography/magnetic resonance imaging before and after intravenous contrast enhancement, and computed tomography angiography and selective cerebral angiography data. Transformed venous drainage pathways were analyzed depending on the location of superior sagittal sinus occlusion by parasagittal meningioma: anterior, middle, or posterior third of the superior sagittal sinus. It was determined that preoperative diagnosis of parasagittal meningiomas that, based on brain computed tomography/magnetic resonance imaging, has signs of type V or VI superior sagittal sinus invasion according M.P. Sindou and J.E. Alvernia, must include selective cerebral angiography. Dynamic images of selective cerebral angiography in the venous phase allows to fully assess the established pathways of collateral blood flow and the blood flow direction. Information on collateral venous circulation in case of superior sagittal sinus occlusion by parasagittal meningioma is extremely important in a surgery planning. It helps avoiding iatrogenic damage to eloquent veins, which increases radical tumor removal with maintaining/improving a patient’s functional state in the early postoperative period and improving long-term treatment outcomes. [ABSTRACT FROM AUTHOR]

Thrombosis significantly affects the overall morbidity and mortality among all ages. Since the clinical picture of thrombosis of the sagittal, transverse, sigmoid sinuses often vague, the diagnosis brings certain difficulties. For this, computed tomography of the brain, phlebography is performed. Approximately, in 1/5 cases of stroke the true cause of occurrence is not established. Conducting molecular genetic typing of hemostasis system factors is one of the ways to solve the problem of etiological pathology. This article presents a clinical case of transverse sinus thrombosis in a postpartum patient with a thrombophilic condition. [ABSTRACT FROM AUTHOR]

Cerebral venous thrombosis is an uncommon and frequently unrecognized type of stroke that affects approximately 5 people per million annually and accounts for 0.5% to 1% of all strokes. CVT is more common in young people. This article discusses the etiology, diagnosis and treatment of CVT with the latest recommendations from the American Heart Association and the American Stroke Association. [ABSTRACT FROM AUTHOR]