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Peer-reviewedCC BY-NC-NDJournal of medical case reports

Superior sagittal sinus thrombosis with intracranial hemorrhage in a patient on infliximab: a case report.

  • Mohammad Rizwan Alam1
  • Juan Corona-Ruiz2
  • Joseph Cahill3
  • William Goldsmith4
  • Michael Sabra4
  • Maro Issac5
  • Peter Fahim6
6 affiliations
  1. 1Internal Medicine Residency Program, UCF/HCA Healthcare Florida West Hospital, Pensacola, FL, USA.
  2. 2Department of Neurosurgery, HCA Healthcare Florida West Hospital, Pensacola, FL, USA.
  3. 3Department of Neurology, HCA Healthcare Florida West Hospital, Pensacola, FL, USA.
  4. 4Department of Critical Care, UCF/HCA Healthcare Florida West Hospital, Pensacola, FL, USA.
  5. 5Faculty of Pharmacy, German University in Cairo, Cairo, Egypt.
  6. 6Department of Critical Care, UCF/HCA Healthcare Florida West Hospital, Pensacola, FL, USA. [email protected].
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Abstract

Background

Superior sagittal sinus thrombosis (SSST) is a rare but life-threatening form of cerebral venous thrombosis. Although several prothrombotic and autoimmune conditions are recognized risk factors, SSST occurring in patients with rheumatoid arthritis (RA) receiving tumor necrosis factor-alpha (TNF-α) inhibitor therapy remains exceptionally rare and poorly described in the literature.Case presentation

We present a 59-year-old Caucasian female with RA treated with infliximab who developed extensive superior sagittal sinus thrombosis with concurrent intracranial and subarachnoid hemorrhage. The patient was managed with anticoagulation, blood pressure control, and seizure prophylaxis, with subsequent clinical and radiologic improvement at one-month follow-up. Hypercoagulability evaluation was overall unrevealing, and no other clear provoking etiology was identified.Conclusions

Given the rarity of this presentation, we report this case to raise awareness of a possible association between cerebral venous thrombosis and TNF-α inhibitor therapy in patients with rheumatoid arthritis. This is especially important given the increasing and widespread use of biologic agents in the treatment of autoimmune diseases.

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Cite

BibTeXRIS
BibTeX
@article{alam2026superior,
  title = {{Superior sagittal sinus thrombosis with intracranial hemorrhage in a patient on infliximab: a case report.}},
  author = {Mohammad Rizwan Alam and Juan Corona-Ruiz and Joseph Cahill and William Goldsmith and Michael Sabra and Maro Issac and Peter Fahim},
  journal = {Journal of medical case reports},
  year = {2026},
  month = jul,
  doi = {10.1186/s13256-026-06355-7},
  url = {https://europepmc.org/article/MED/42902419},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Superior sagittal sinus thrombosis with intracranial hemorrhage in a patient on infliximab: a case report.
AU  - Mohammad Rizwan Alam
AU  - Juan Corona-Ruiz
AU  - Joseph Cahill
AU  - William Goldsmith
AU  - Michael Sabra
AU  - Maro Issac
AU  - Peter Fahim
PY  - 2026
DA  - 2026/07/01
JO  - Journal of medical case reports
DO  - 10.1186/s13256-026-06355-7
UR  - https://europepmc.org/article/MED/42902419
AB  - Background  Superior sagittal sinus thrombosis (SSST) is a rare but life-threatening form of cerebral venous thrombosis. Although several prothrombotic and autoimmune conditions are recognized risk factors, SSST occurring in patients with rheumatoid arthritis (RA) receiving tumor necrosis factor-alpha (TNF-α) inhibitor therapy remains exceptionally rare and poorly described in the literature.Case presentation  We present a 59-year-old Caucasian female with RA treated with infliximab who developed extensive superior sagittal sinus thrombosis with concurrent intracranial and subarachnoid hemorrhage. The patient was managed with anticoagulation, blood pressure control, and seizure prophylaxis, with subsequent clinical and radiologic improvement at one-month follow-up. Hypercoagulability evaluation was overall unrevealing, and no other clear provoking etiology was identified.Conclusions  Given the rarity of this presentation, we report this case to raise awareness of a possible association between cerebral venous thrombosis and TNF-α inhibitor therapy in patients with rheumatoid arthritis. This is especially important given the increasing and widespread use of biologic agents in the treatment of autoimmune diseases.
SN  - 1752-1947
ER  -