Saneto R P, Samples S, Kinkel R P
Departments of Pediatric Neurology, Cleveland Clinic Foundation, Ohio 44195, USA.
Headache. 2000 Jul-Aug;40(7):595-8. doi: 10.1046/j.1526-4610.2000.00093.x.
To describe the occurrence of cerebral venous thrombosis in a 40-year-old man whose cerebral event was induced by a poor golf swing, to review the literature on possible mechanisms producing venous thrombosis, and to compare this case with the literature.
Headache is the most frequent symptom in patients with cerebral venous thrombosis. However, patients presenting with a headache due to cerebral venous thrombosis are uncommon. The known risk factors for thrombosis include both acquired and genetic factors. When the interaction of these two groups occurs, the magnitude of this interaction is thought to produce a dynamic state that can favor thrombosis. Our case report illustrates that moderate levels of anticardiolipin antibodies together with the mild trauma of a golf swing can induce a cerebral venous thrombosis. This case also suggests that although headache is rarely due to cerebral venous thrombosis, it should be excluded by good medical acumen and testing.
Minor trauma induced by a poor golf swing was chronologically related to the development of a progressive cerebral venous thrombosis. The patient had none of the risk factors associated with a predisposition to venous thrombosis: hypercoagulable state, concurrent infection, pregnancy/puerperium, collagen vascular disorder, malignancy, migraine, false-positive VDRL, previous deep vein thrombosis, renal disease, factor V Leiden, or a hematological disorder. There was no anatomical abnormality that would predispose the patient to a cerebral venous thrombosis. The only laboratory abnormality was a moderate anticardiolipin antibody level (25 GPL). The patient was placed on warfarin sodium therapy and is currently without clinical sequela from the venous thrombotic event.
Under certain circumstances, minor trauma can induce cerebral venous thrombosis. A review of the literature indicates that cerebral venous thrombosis in the presence of anticardiolipin antibodies and in the absence of systemic lupus erythematosus is a rare event. Previously, only major traumatic events have been reported to be associated with cerebral venous thromboses. The chronological development of cerebral venous thrombosis after a faulty golf swing strongly indicates that given a background of moderate levels of anticardiolipin antibodies, even minor trauma can induce a venous thrombotic event.
描述一名40岁男性因高尔夫挥杆动作不佳引发脑部事件后发生脑静脉血栓形成的情况，回顾关于导致静脉血栓形成的可能机制的文献，并将该病例与文献进行比较。
头痛是脑静脉血栓形成患者最常见的症状。然而，因脑静脉血栓形成而出现头痛的患者并不常见。已知的血栓形成危险因素包括获得性因素和遗传因素。当这两组因素相互作用时，这种相互作用的程度被认为会产生一种有利于血栓形成的动态状态。我们的病例报告表明，中度水平的抗心磷脂抗体与高尔夫挥杆的轻度创伤共同作用可诱发脑静脉血栓形成。该病例还表明，尽管头痛很少由脑静脉血栓形成引起，但应凭借良好的医学敏锐度和检查予以排除。
高尔夫挥杆动作不佳导致的轻微创伤在时间上与进行性脑静脉血栓形成的发展相关。该患者没有与静脉血栓形成易感性相关的危险因素：高凝状态、并发感染、妊娠/产褥期、胶原血管疾病、恶性肿瘤、偏头痛、梅毒血清学试验假阳性、既往深静脉血栓形成、肾脏疾病、凝血因子V Leiden突变或血液系统疾病。没有解剖学异常使该患者易患脑静脉血栓形成。唯一的实验室异常是抗心磷脂抗体水平中度升高（25 GPL）。该患者接受了华法林钠治疗，目前没有静脉血栓形成事件的临床后遗症。
在某些情况下，轻微创伤可诱发脑静脉血栓形成。文献回顾表明，存在抗心磷脂抗体且无系统性红斑狼疮的情况下发生脑静脉血栓形成是罕见事件。此前，仅有重大创伤事件被报道与脑静脉血栓形成有关。高尔夫挥杆动作失误后脑静脉血栓形成的时间发展强烈表明，在中度抗心磷脂抗体水平的背景下，即使是轻微创伤也可诱发静脉血栓形成事件。
