Cerebral Venous Thrombosis in Pediatric Oncology: A Case of Burkitt Lymphoma

Abstract

Cerebral venous thrombosis (CVT) is an uncommon but serious complication in pediatric patients with cancer. We report the case of a nine-year-old boy diagnosed with Burkitt lymphoma involving the nasopharyngeal region, who developed superior sagittal sinus thrombosis during chemotherapy. Neurological examination prior to treatment revealed no signs of intracranial hypertension. However, two weeks after completing the first course of chemotherapy, the patient presented with severe headaches and intermittent vomiting. Neuroimaging confirmed cerebral venous thrombosis, while the tumor mass was regressing. Anticoagulant therapy with low-molecular-weight heparin was initiated and carefully adjusted in response to chemotherapy-induced thrombocytopenia. Clinical evolution was favorable, with complete neurological recovery and radiological resolution of the thrombus. This case emphasizes the importance of early recognition of CVT in pediatric oncology, especially when neurological symptoms occur during chemotherapy, even in the absence of prior intracranial hypertension. It also highlights the challenges of anticoagulant management in the context of treatment-related thrombocytopenia.