Cerebral Sinovenous Thrombosis and Subdural Hematoma as Treatment-Related Complications in Suprasellar Germ Cell Tumor Associated with Adipsic Diabetes Insipidus

Pediatr Neurosurg. 2019;54(4):288-292. doi: 10.1159/000501044. Epub 2019 Jul 10.

Abstract

Cerebral sinovenous thrombosis (CSVT) is a rare but not a negligible complication in pediatric brain tumor. An 11-year-old male with suprasellar germ cell tumor developed treatment-related vascular complications of CSVT and subdural hematoma. The underlying mechanism of CSVT was attributed to multiple risk factors, such as adipsic diabetes insipidus, obesity, central apnea, and chemotherapy-induced endothelial injury. In an attempt to minimize the possible risk of vascular complications, including late effect in pediatric brain tumors, we would like to stress the importance of individualized supportive therapy, i.e., hormone replacement, fluid management, thromboprophylaxis, and bi-level positive airway pressure therapy.

Keywords: Adipsic diabetes insipidus; Central apnea; Cerebral sinovenous thrombosis; Chemotherapy; Endothelial injury.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants
  • Child
  • Diabetes Insipidus / complications*
  • Drug Therapy
  • Germinoma / complications*
  • Germinoma / diagnosis
  • Hematoma, Subdural / complications*
  • Hematoma, Subdural / therapy
  • Humans
  • Male
  • Obesity / complications
  • Pituitary Neoplasms / complications*
  • Sinus Thrombosis, Intracranial / complications*
  • Sinus Thrombosis, Intracranial / therapy

Substances

  • Anticoagulants