Shigemori Yutaka, Koshinaga Morimichi, Suma Takeshi, Katayama Yoichi
Department of Neurological Surgery, Nihon University, School of Medicine, 30-1, Oyaguchi-Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
No Shinkei Geka. 2006 Sep;34(9):939-42.
A case of superior sagittal sinus thrombosis which was complicated with ulcerative colitis is reported. A 16-year-old male patient had a 2-year history of ulcerative colitis. He was admitted to our hospital complaining of abdominal pain, bloody bowel discharge and appetite loss, and was then treated conservatively. Two days after admission, he demonstrated generalized convulsions which were followed by right hemiplegia. MRI showed a low intensity lesion on T1 and an irregular high intensity in the subcortical area of the left frontal lobe on T2 and T2 FLAIR-weighted images. The MRI findings resembled either invasive brain tumor or local inflammation. Cerebral angiography appeared to demonstrate complete obstruction of the superior sagittal sinus with congestion of venous flow in the cortical veins. Ulcerative colitis has been reported to show hypercoagulation, leading to deep vein thrombosis within the body which sometimes causes pulmonary infarction; however, occurrence of venous thrombosis in the intracranial veins and sinus is rare. This report underscores the fact that cerebral venous thrombosis should be suspected in the case of patients with ulceritive colitis who suffer sudden onset of neurological deficits.
报告了一例并发溃疡性结肠炎的上矢状窦血栓形成病例。一名16岁男性患者有2年溃疡性结肠炎病史。他因腹痛、便血和食欲不振入院，随后接受保守治疗。入院两天后，他出现全身性惊厥，随后出现右侧偏瘫。MRI在T1加权像上显示低强度病变，在T2加权像和T2 FLAIR加权像上左侧额叶皮质下区域出现不规则高强度信号。MRI表现类似于侵袭性脑肿瘤或局部炎症。脑血管造影显示上矢状窦完全阻塞，皮质静脉血流淤滞。据报道，溃疡性结肠炎可出现高凝状态，导致体内深静脉血栓形成，有时会引起肺梗死；然而，颅内静脉和静脉窦发生静脉血栓形成的情况很少见。本报告强调，对于患有溃疡性结肠炎且突然出现神经功能缺损的患者，应怀疑有脑静脉血栓形成。
