• Tao Peng, Zini Zhang, Bifeng Zu, and Bitang Dan.
• Department of Neurology, the Third People's Hospital of Hubei Province, Wuhan, PR China.
• Medicine (Baltimore). 2021 Sep 3; 100 (35): e27024e27024.

RationaleCerebral venous sinus thrombosis associated with protein S deficiency is rare in adolescent patients and has high disability and fatality.Patient concerns: A 15-year-old male student presented in the hospital with sudden headache, nausea, and vomiting and was diagnosed with protein S deficiency by gene testing.DiagnosesCerebral venous sinus thrombosis due to protein S deficiency was diagnosed in this adolescent patient, who underwent successful endovascular therapy (EVT).InterventionsThe patient was treated with standard anti-coagulation therapy including low-molecular-weight heparin (90 IU/kg/Q12 h) and dehydrant (mannitol 125 mL Q8 h); however, the symptoms were not alleviated. Successful EVT was implemented.OutcomesBoth the superior sagittal sinus and bilateral transverse sinus were recanalized after thrombus clearance. The patient achieved a complete recovery without any other stroke recurrence during follow-up.LessonsEVT can be performed with favorable and effective clinical outcomes in adolescent cerebral venous sinus thrombosis patients with protein S deficiency. EVT associated with standard anti-coagulation therapy may improve the prognosis and reduce mortality among such patients.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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