Ushiwata I, Saiki I, Murakami T, Kanaya H, Konno J, Wada S
Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
No Shinkei Geka. 1989 Jan;17(1):51-5.
This case report deals with transverse sinus thrombosis accompanied by intracerebellar hemorrhage. A 33-year-old woman had sudden onset of headache, vomiting, and disturbance of consciousness. Computed Tomography (CT) scan showed left intracerebellar hematoma, while vertebral angiography revealed no visualization of the transverse sinus and cerebellar cortical veins on the left side. Evacuation of the intracerebellar hematoma along with decompression of the posterior fossa was carried out. Findings of the histopathological examination of the operation specimen showed the cortical veins to be filled with fresh thrombus and softened cerebellar parenchyma mixed with many small clots. Until now, cases such as hemorrhagic infarction in the cerebellum, due to transverse sinus thrombosis have not yet been reported. It is considered that there is much more collateral circulation in the infratentorial region rather than in the supratentorial region. This indicates that cerebellum hemorrhagic infarction rarely occurs due to transverse sinus thrombosis. In our case, the inflammation of the cortical veins (thrombophlebitis) was thought to have disturbed the collateral circulation in the cerebellum.
本病例报告涉及伴有小脑内出血的横窦血栓形成。一名33岁女性突然出现头痛、呕吐及意识障碍。计算机断层扫描（CT）显示左侧小脑内血肿，而椎动脉造影显示左侧横窦及小脑皮质静脉未显影。行小脑内血肿清除术及后颅窝减压术。手术标本的组织病理学检查结果显示皮质静脉内充满新鲜血栓，软化的小脑实质内混有许多小血块。迄今为止，尚未有因横窦血栓形成导致小脑出血性梗死的病例报道。一般认为幕下区域的侧支循环比幕上区域丰富得多。这表明因横窦血栓形成导致小脑出血性梗死很少发生。在我们的病例中，皮质静脉炎症（血栓性静脉炎）被认为干扰了小脑的侧支循环。
