Neurologic signs and symptoms in acute lymphocytic leukemia are often secondary to CNS leukemia.1 Cerebrospinal fluid pleocytosis is usually present in such cases.1 Dural sinus occlusion is a rare complication of CNS leukemia and may produce neurologic signs and symptoms without CSF pleocytosis.2 We recently evaluated a patient with acute lymphocytic leukemia in bone marrow remission. Signs and symptoms of CNS leukemia developed in this patient, without CSF pleocytosis. There was occlusion of the superior sagittal sinus and other major venous channels but no evidence of infection or CNS leukemia. This seems to be a unique occurrence.
Report of a Case.—The condition of a 6-year, 3-month-old boy was evaluated on Dec 9, 1977, for lethargy and headache. He was first seen at the University of Wisconsin Hospitals, Madison, at age 5 years for abdominal distension, fever, and drowsiness. Peripheral WBC count was 45,900/cu mm, with 60%