# Extensive Dural Venous Thrombosis With Associated Intracerebral Hemorrhage and Subarachnoid Hemorrhage Due to Protein S Deficiency: A Case Report

## TL;DR

A 63-year-old woman with protein S deficiency developed severe brain blood clots and bleeding, which improved with anticoagulation treatment.

## Contribution

This case report highlights a rare presentation of cerebral venous thrombosis with hemorrhage in a patient with protein S deficiency.

## Key findings

- The patient had extensive dural venous thrombosis with intracerebral and subarachnoid hemorrhage.
- Anticoagulation treatment led to clinical and radiographic improvement.
- Protein S deficiency was identified as an underlying cause of the thrombosis.

## Abstract

Cerebral venous thrombosis (CVT) is an uncommon but potentially severe condition, typically affecting younger individuals, pregnant women, and those with underlying thrombophilia. We report a rare case of a 63-year-old female who presented with altered mental status, facial droop, and slurred speech and was found to have an extensive dural venous thrombosis complicated by intracerebral and subarachnoid hemorrhage due to protein S deficiency. Given her diagnosis of protein S deficiency and thrombosis, careful anticoagulation was initiated, resulting in both clinical and radiographic improvement.