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一名先兆子痫妇女发生脑静脉窦血栓形成和后部可逆性脑病综合征。

Cerebral venous sinus thrombosis and posterior reversible encephalopathy syndrome in a preeclamptic woman.

作者信息

KöRoglu Nadiye, Sudolmus Sinem, Sarioglu Elif Asli, Alkan Alpay, Dansuk Ramazan

机构信息

Specialist, Department of Obstetrics and Gynaecology, Bezmialem Vakif University , Istanbul, Turkey .

Senior Resident, Department of Obstetrics and Gynaecology, Bezmialem Vakif University , Istanbul, Turkey .

出版信息

J Clin Diagn Res. 2015 Jan;9(1):QD09-11. doi: 10.7860/JCDR/2015/9420.5408. Epub 2015 Jan 1.

Abstract

Cerebral venous sinus thrombosis (CVST) and posterior reversible encephalopathy syndrome (PRES) are two rare diseases which may present with similar symptoms and signs. We report a case with coexisting PRES and CVST in a preeclamptic woman. A 24-year-old woman, G2 P1, at 33 wk and 5 d of pregnancy presented with headache. Her blood pressure was 180/120 mmHg and urinary test revealed +3proteinuria. Cesarean section was performed with indications of severe preeclampsia, intrauterine growth retardation and fetal distress. Cranial MR venography of the patient revealed thrombiin superior sagittal sinus, confluenssinuum, right transverse and right sigmoid sinus and diffusion MRI showed increased signal intensity (vasogenicoedema) in cortical and subcortical areas of parietooccipital and posterior frontal lobes.The patient was treated with magnesium sulfate and heparin successfully. After treatment period, control cranial MRI and diffusion MRI were normal. Thrombi within the sinuses were totally regressed. Albeit rare, these two diseases should be kept in mind especially in preeclamptic/eclamptic patients that present with neurological symptom and/or sign.

摘要

脑静脉窦血栓形成(CVST)和后部可逆性脑病综合征(PRES)是两种罕见疾病,可能表现出相似的症状和体征。我们报告一例子痫前期女性同时存在PRES和CVST的病例。一名24岁女性,孕2产1,妊娠33周5天时出现头痛。她的血压为180/120 mmHg,尿检显示蛋白尿+++。因重度子痫前期、胎儿生长受限和胎儿窘迫行剖宫产术。患者的头颅磁共振静脉血管造影显示上矢状窦、窦汇、右侧横窦和右侧乙状窦有血栓形成,弥散加权成像显示顶枕叶和额叶后部皮质及皮质下区域信号强度增加(血管源性水肿)。患者经硫酸镁和肝素治疗成功。治疗后,头颅磁共振成像和弥散加权成像检查正常。窦内血栓完全消退。尽管这两种疾病罕见,但对于出现神经症状和/或体征的子痫前期/子痫患者应特别予以关注。

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