Fatal brain swelling due to superior vena cava syndrome

Introduction: Brain swelling is an unusual complication of superior vena cava syndrome. It is unknown if the condition is reversible. Case: We present a 58 year old woman with metastatic colon carcinoma presenting with facial swelling and upper trunk ecchymosis, rapid onset of coma and extensor posturing on admission. CT showed diffuse cerebral edema and evolving parenchymal hypodensities. An occlusive thrombus at the site of an indwelling intravascular access was successfully removed with thrombectomy,but the patient progressed to brain death. Conclusion: This is the first case of fatal cerebral edema from a superior vena cava syndrome. The underlying malignancy may have induced a clotting disorder.