Ogata Toshiyasu, Kamouchi Masahiro, Kitazono Takanari, Kuroda Junya, Ooboshi Hiroaki, Shono Tadahisa, Morioka Takato, Ibayashi Setsuro, Sasaki Tomio, Iida Mitsuo
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Stroke Cerebrovasc Dis. 2008 Nov-Dec;17(6):426-8. doi: 10.1016/j.jstrokecerebrovasdis.2008.04.008.
A 55-year-old man presented with generalized seizures and postictal left hemiparesis. Computed tomography scanning of his head showed a low density area in the right frontal lobe. Cerebral angiography demonstrated a partial defect in the superior sagittal sinus and cortical veins, indicating the presence of cerebral venous thrombosis. He had bleeding from a peptic ulcer and the laboratory data revealed iron deficiency anemia concomitant with an elevation of D-dimer and thrombin-antithrombin III complex (TAT). After the anemia resolved with the treatment of the peptic ulcer and iron supplementation, the TAT and D-dimer levels were normalized, and the occluded veins were recanalized. In a cerebral venous thrombosis associated with iron deficiency anemia, treatment for the anemia may improve hypercoagulable state without antithrombotic therapy, although the long-term monitoring of TAT and D-dimer levels is required.
一名55岁男性出现全身性癫痫发作及发作后左侧偏瘫。其头部计算机断层扫描显示右额叶有低密度区。脑血管造影显示上矢状窦和皮质静脉有部分缺损,提示存在脑静脉血栓形成。他有消化性溃疡出血,实验室检查数据显示缺铁性贫血,同时D - 二聚体和凝血酶 - 抗凝血酶III复合物(TAT)升高。在消化性溃疡经治疗及补充铁剂后贫血得到缓解,TAT和D - 二聚体水平恢复正常,闭塞的静脉再通。在与缺铁性贫血相关的脑静脉血栓形成中,对贫血的治疗可能在不进行抗血栓治疗的情况下改善高凝状态,不过需要长期监测TAT和D - 二聚体水平。