Tsujikawa T, Urabe M, Bamba H, Andoh A, Sasaki M, Koyama S, Fujiyama Y, Bamba T
The Second Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
J Gastroenterol Hepatol. 2000 Jun;15(6):688-92. doi: 10.1046/j.1440-1746.2000.02190.x.
A 29-year-old man with ulcerative colitis was admitted to our hospital because of convulsions and a headache. Before admission, oral prednisolone had been administered due to his ulcerative colitis relapse. Computed tomography revealed a low-density area in the right frontal pole suggestive of a venous infarction. Once his headache and convulsions improved after the administration of an antiepileptic drug, he began to complain of right arm numbness and right hemianopsia again. An urgent magnetic resonance imaging angiograph showed extensive thrombosis in the superior sagittal sinus. We finally used the anticoagulant agents, heparin and urokinase, which eased his complaints and prevented the development of bloody stools. He was discharged with no neurological symptoms 25 days after admission. This is a rare case of sinus thrombosis complicated by ulcerative colitis, in which anticoagulant therapy was successful. Magnetic resonance imaging angiography was useful for the diagnosis and for evaluating the therapeutic effect.
一名29岁的溃疡性结肠炎男性因抽搐和头痛入院。入院前,因其溃疡性结肠炎复发,已给予口服泼尼松龙治疗。计算机断层扫描显示右额叶极有一个低密度区,提示静脉梗死。在给予抗癫痫药物后,他的头痛和抽搐症状有所改善,但随后又开始抱怨右臂麻木和右侧偏盲。紧急磁共振血管造影显示上矢状窦广泛血栓形成。我们最终使用了抗凝剂肝素和尿激酶,这缓解了他的症状并预防了血便的发生。入院25天后,他出院时没有神经症状。这是一例罕见的溃疡性结肠炎合并窦血栓形成的病例,抗凝治疗取得了成功。磁共振血管造影对诊断和评估治疗效果很有用。