A neurological complication of a uterine fibroid

Background: Uterine leiomyoma (or fibroid) can be associated with secondary polycythemia and venous thrombosis, but there has been no report of intracranial venous thrombosis associated with leiomyoma. Methods: We describe a case report of a cerebral venous thrombosis associated with erythrocytosis and a uterine fibroid in a non-smoking female with no history of malignancy or hormone use. The hemoglobin and erythropoietin normalized after removal of her uterine fibroid. Results: MRI/MRV of this 60-year-old cephalalgic female revealed extensive thrombus throughout the sagittal sinus and right transverse sinus. CT of the abdomen revealed a 16 × 13 × 12 cm solid mass arising for the uterus consistent with a uterine fibroid. PET scan was negative for malignancy. Hemoglobin on admission was 18.4 g/dl. Erythropoietin was 16.6 mIU/ml. One month after hysterectomy, her hemoglobin was 12.6 g/dl and her erythropoietin was 4.7 mIU/ml. Conclusions: Cerebral vein thrombosis is a potential complication of uterine fibroids with erythrocytosis.