Wang Yuan, Meng Ran, Duan Jiangang, Liu Gang, Chen Jian, Li Sijie, Ji Xunming
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Cerebral Vascular Diseases Research Institute (China-America Institute of Neuroscience), Xuanwu Hospital, Beijing Institute for Brain Disorders, Capital Medical University and the Center of Stroke, Beijing, China.
Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
J Stroke Cerebrovasc Dis. 2016 Oct;25(10):2415-22. doi: 10.1016/j.jstrokecerebrovasdis.2016.06.013. Epub 2016 Jun 24.
Thrombosis is a common complication of nephrotic syndrome (NS). However, cerebral venous sinus thrombosis (CVST) secondary to NS is rarely reported. Here we report a case series study of 5 cases of CVST with NS, so as to make a better understanding and management of this disorder.
A retrospective study was performed in 5 consecutive patients with CVST in combination with NS between 2009 and 2015. The clinical manifestations, laboratory and radiological findings, treatment, and clinical outcomes were analyzed.
This cohort of case series consists of 1 woman and 4 men, aged 16-49 years. All patients complained initially of an acute or subacute headache. CVST attacked during NS occurrence in 3 patients, and during NS recurrence in 2 patients. The median duration of signs and symptoms prior to clinical diagnosis and treatment was 12.80 ± 7.53 days. In all patients, it was magnetic resonance venography that detected the thrombosis in the cerebral venous sinus, with the most common site of CVST to be the superior sagittal sinus (5 of 5 patients). Two or more segments of sinus were involved simultaneously in 4 patients. The treatment of CVST in NS involved therapy of CVST in the general population. All the 5 patients had full recovery, and no one relapsed with a follow-up of 26.60 ± 29.75 months.
NS may be one of the important etiologies of CVST. When patients with NS had progressing headache, seizure, or other unexplained neurological symptoms, CVST should be considered.
血栓形成是肾病综合征（NS）的常见并发症。然而，继发于NS的脑静脉窦血栓形成（CVST）鲜有报道。在此，我们报告一项关于5例NS合并CVST患者的病例系列研究，以便更好地认识和处理这种疾病。
对2009年至2015年间连续5例CVST合并NS的患者进行回顾性研究。分析其临床表现、实验室及影像学检查结果、治疗情况及临床结局。
该病例系列包括1名女性和4名男性，年龄在16至49岁之间。所有患者最初均主诉急性或亚急性头痛。3例患者CVST发生于NS起病时，2例患者发生于NS复发时。临床诊断和治疗前症状和体征的中位持续时间为12.80±7.53天。所有患者均通过磁共振静脉血管造影检测到脑静脉窦血栓形成，CVST最常见的部位是上矢状窦（5例患者均为此处）。4例患者同时累及两个或更多节段的静脉窦。NS合并CVST的治疗采用一般人群CVST的治疗方法。所有5例患者均完全康复，随访26.60±29.75个月无复发。
NS可能是CVST的重要病因之一。当NS患者出现进行性头痛、癫痫发作或其他无法解释的神经系统症状时，应考虑CVST。
