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BACKGROUND Cerebral venous complications related to neurosurgical interventions are only rarely reported in the literature. Internal cerebral veins (ICVs) are vulnerable to injury during neurosurgical approaches to the pineal and thalamic regions. The occurrence of unilateral postoperative ICV thrombosis in children is extremely rare, with only two such cases reported thus far. CASE DESCRIPTION A 15-year-old child presented to the emergency department with headache, persistent vomiting and pronounced lethargy for three days. Magnetic re