Sasiadek Marek J, Sosnowska-Pacuszko Dorota, Zielinska Marzena, Turek Tomasz
Department of Neuroradiology, Wroclaw Medical University, and Department of Radiology, T. Marciniak Memorial Hospital, Wroclaw, Poland.
Pediatr Neurol. 2006 Aug;35(2):135-8. doi: 10.1016/j.pediatrneurol.2006.01.010.
This report presents a case of cerebral venous thrombosis and venous infarction in a diabetic patient, the third in the world literature (the second in a child). An 8-year-old male was admitted to the hospital due to abdominal pain, vomiting, polydypsia, and polyuria, lasting for 4 days. Laboratory studies revealed marked hyperglycemia and ketoacidosis. Two hours after admission the child lost consciousness. Emergency computed tomography performed 3 hours after admission (4 days after the onset of symptoms) revealed hyperdensity in the vein of Galen and superior sagittal sinus, consistent with thrombosis, accompanied by bilateral venous infarction. Follow-up computed tomography performed 6 days after admission (10 days after the onset of symptoms) documented evolution of thrombosis. Magnetic resonance imaging and magnetic resonance venography performed 22 days after admission (26 days after the onset of symptoms) confirmed venous infarction and thrombosis. This report discusses possible mechanisms of cerebral venous thrombosis in diabetic hyperglycemia and stresses the importance of imaging studies despite the extreme rarity of such cases.
本报告介绍了一例糖尿病患者发生脑静脉血栓形成和静脉梗死的病例，这是世界文献中的第三例（儿童中的第二例）。一名8岁男性因腹痛、呕吐、烦渴和多尿入院，症状持续4天。实验室检查显示明显的高血糖和酮症酸中毒。入院两小时后患儿失去意识。入院3小时后（症状出现4天后）进行的急诊计算机断层扫描显示大脑大静脉和上矢状窦高密度影，符合血栓形成，并伴有双侧静脉梗死。入院6天后（症状出现10天后）进行的随访计算机断层扫描记录了血栓形成的演变。入院22天后（症状出现26天后）进行的磁共振成像和磁共振静脉造影证实了静脉梗死和血栓形成。本报告讨论了糖尿病高血糖状态下脑静脉血栓形成的可能机制，并强调了尽管此类病例极为罕见，但影像学检查的重要性。
