Malignant cutaneous melanoma associated with cerebral venous sinus thrombosis

Cerebral venous sinus thrombosis (CVST) is an infrequent disease (representing around 1% of all strokes) manifested by clotting of blood in cerebral venous or dural sinuses as well as cortical veins. Herein, we describe an unusual case of malignant melanoma presenting with CVST in whom the diagnosis of CVST was suspected on the basis of clinical findings along with brain CT scan, and finally was confirmed by brain MRI and magnetic resonance venography. Intravenous heparin treatment was started immediately; but unfortunately the patient died one week after hospitalization. We suggest that the hypercoagulable state provoked by malignant melanoma generated the CVST as brain MRI did not indicate any evidence of brain metastasis; therefore, direct invasion of the sinus by the tumor is less likely; on the other hand, we should not omit the possible role of microscopic sinus metastasis.