It is well known that hypercortisolism induced by Cushing’s disease and syndrome, or by administration of glucocorticoids, causes thromboembolic complications.¹ However, the precise mechanisms underlying the hypercortisolism induced hypercoagulable state still remain unknown. Here we describe a case of cerebral lateral sinus thrombosis with Cushing’s syndrome. Glucocorticoid induced overproduction of factor VIII and von Willebrand factor (VWF) may have contributed to the development of the cerebral sinus thrombosis in this patient.

Case report

A mildly obese 30 year old woman was admitted to our hospital because of headache and nausea. She was not taking any medications, including oral contraceptives, before admission. The patient had no intracranial hypertension; her fundi showed no papillo-oedema, and intracranial pressure measured by lumbar puncture was normal (14.3 mmHg). Brain computed tomogram (CT) showed a high density lesion in the left temporo-occipital lobe (fig 1A). Magnetic resonance venogram (MRV) on the first hospitalised day showed a filling defect in the left lateral sinus (fig 1B). These findings were consistent with cerebral lateral sinus thrombosis.