Cerebral Venous Thrombosis Involving the Vein of Labbé and Left Sigmoid Sinus in a Patient With Immune Thrombocytopenia Treated With Romiplostim: A Case Report and Literature Review
Case report published in Cureus (2026)
Abstract
Cerebral venous thrombosis is an uncommon but potentially serious condition primarily affecting young women. Thrombosis of the vein of Labbé is a rare site of thrombosis linked to hemorrhagic venous infarction. Thrombotic events have been reported in patients with chronic primary immune thrombocytopenia (ITP) treated with thrombopoietin receptor agonists (TPO-RAs). A 33-year-old woman with chronic ITP, treated with romiplostim for five years, presented with a progressively worsening occipital headache and a generalized seizure. Computed tomography showed a left parietotemporal intraparenchymal hemorrhage. Magnetic resonance imaging and venography confirmed left sigmoid sinus thrombosis and a hemorrhagic venous infarction caused by thrombosis of the vein of Labbé, along with signs indicating a previous superior sagittal sinus thrombosis. Romiplostim was discontinued after the event, and anticoagulation, along with corticosteroids, was started due to a decline in platelet count. Common causes of cerebral venous thrombosis were investigated and ruled out. The patient was discharged asymptomatic on hospital day 12 and was seen for outpatient follow-up. This case highlights a rare presentation of Labbé vein thrombosis in the setting of long-term use of TPO-RAs and supports a possible association.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Cerebral venous thrombosis is an uncommon but potentially serious condition primarily affecting young women. Thrombosis of the vein of Labbé is a rare site of thrombosis linked to hemorrhagic venous infarction.
Why This Matters for Hirudotherapy
This case report describes a 33-year-old woman with chronic immune thrombocytopenia who developed cerebral venous thrombosis involving the vein of Labbé and left sigmoid sinus after five years of romiplostim therapy, presenting with hemorrhagic venous infarction and seizure. The report supports a possible association between thrombopoietin receptor agonists and thrombotic events. For the hirudotherapy community, the case illustrates the broader challenge of anticoagulation in thrombocytopenic patients with venous thrombosis—a clinical context where understanding anticoagulant options, including hirudin-derived direct thrombin inhibitors, is relevant to management decisions. However, this is a single patient report documenting a temporal association rather than proving causation, and the abstract does not specify which anticoagulant was used.
Citation
Cerebral Venous Thrombosis Involving the Vein of Labbé and Left Sigmoid Sinus in a Patient With Immune Thrombocytopenia Treated With Romiplostim: A Case Report and Literature Review.
Berrocal C et al. · Cureus, 2026
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