Ohsaka Misuzu, Nonaka Tadashi, Oka Shinichi, Minamida Yoshihiro, Mikami Takeshi
Department of Neurosurgery, Sapporo Medical University School of Medicine.
No To Shinkei. 2006 Jan;58(1):57-61.
A 33-year-old female who had been on a steroid treatment for the past 14 years due to systemic lupus erythematosus (SLE) visited our hospital complaining of mild headache. No neurological deficit and no positive serologic tests for lupus anticoagulants (LAC) and anticardiolipin antibodies (aCL) were noted. Only a mild inflammatory change was observed on routine hematological examination. On neuroradiological examination, MRI revealed thickened falx cerebri and tentorium cerebelli, and an empty delta sign. These findings were suggestive of sinus thrombosis of superior sagittal sinus (SSS). Angiograms clearly demonstrated occlusion of the posterior part of superior sagittal sinus and transeverse sinus (TS). Conservative treatment was chosen because of no evidence of intracranial hypertension. There was no deterioration in her general and neurological status during her hospital stay and she was discharged. Longstanding vasculitis and pachymeningitis related to lupus erythematosus might be the probable cause of the sinus thrombosis in this case.
一名33岁女性,因系统性红斑狼疮(SLE)接受了14年的类固醇治疗,因轻度头痛前来我院就诊。未发现神经功能缺损,狼疮抗凝物(LAC)和抗心磷脂抗体(aCL)的血清学检查均为阴性。常规血液学检查仅观察到轻度炎症变化。神经放射学检查显示,MRI发现大脑镰和小脑幕增厚,以及空三角征。这些发现提示上矢状窦(SSS)血栓形成。血管造影清楚地显示上矢状窦后部和横窦(TS)闭塞。由于没有颅内高压的证据,选择了保守治疗。住院期间,她的一般状况和神经状态没有恶化,随后出院。长期存在的与红斑狼疮相关的血管炎和硬脑膜炎可能是该病例中窦血栓形成的可能原因。