Beyond the usual workup: severe hypertriglyceridemia as a potential cause of cerebral venous thrombosis

Hypertriglyceridemia and cerebral venous thrombosis are well-recognized complications of asparaginase therapy for B-cell acute lymphoblastic leukemia. Hypertriglyceridemia has also been associated with an increased risk of thrombosis in conditions such as Behçet’s disease and has been implicated in a pediatric case of cerebral venous thrombosis, suggesting a possible link between hypertriglyceridemia and cerebral venous thrombosis. We present the case of a patient with acute delirium and amnesia, revealing a venous infarction caused by cerebral venous thrombosis of the sinus rectus. Classical causes, including hereditary thrombophilia, were excluded. Notably, the patient’s blood appeared lactescent at admission, and laboratory testing revealed severe hypertriglyceridemia. The patient improved significantly with heparin, dietary modifications, and ciprofibrate. This case suggests that severe hypertriglyceridemia should be considered as a potential trigger of cerebral venous thrombosis and that including a lipid panel in cerebral venous thrombosis work-ups could be considered, allowing subsequent specific therapeutic interventions.