Lemierre’s Syndrome Complicated by Venous Stroke due to a Massive Cerebral Venous Thrombus

Abstract

Lemierre’s syndrome is a rare disease characterized by thrombophlebitis of the internal jugular vein and metastasis to distant organs. It occurs after an anaerobic infection of the larynx or dental region; the central nervous system involvement is infrequent. A 50-year-old woman presented with impaired consciousness. She had undergone several days of dental treatment for a toothache before presentation. Contrast-enhanced computed tomography (CT) revealed a head-and-neck abscess and a massive thrombus in the internal jugular vein, and a diagnosis of Lemierre’s syndrome was made. After symptoms improved with surgical drainage and antimicrobial therapy, the patient was discharged on day 58. In this case, Lemierre’s syndrome was complicated by a venous stroke caused by venous congestion due to a massive cerebral venous thrombus. Venous stroke due to thrombi may occur in patients with Lemierre’s syndrome, and magnetic resonance imaging or CT with venous phase imaging may aid in the diagnosis.

Keywords

• intracranial thrombosis
• lemierre’s syndrome
• stroke
• thrombosis
• venous thromboembolism