Sotoodehnia Mehran, Safaei Arash, Rasooli Fatemeh, Bahreini Maryam
Tehran University of Medical Sciences, Department of Emergency Medicine, Sina Hospital, Hasan Abad Square, Imam Khomeini Ave, Tehran, Iran.
Tehran University of Medical Sciences, Department of Emergency Medicine, Sina Hospital, Hasan Abad Square, Imam Khomeini Ave, Tehran, Iran.
Am J Emerg Med. 2017 Jun;35(6):934.e1-934.e2. doi: 10.1016/j.ajem.2016.12.028. Epub 2016 Dec 12.
The diagnosis of cerebral venous sinus thrombosis still remains a real challenge. Seizure, unusual headache with sudden onset, unexplained persistently unilateral vascular headache and neurologic deficit-which is difficult to be attributed to a vascular territory are some of the suggestive symptoms.
An isolated sixth nerve palsy is discussed as a rare presentation for cerebral venous thrombosis. Following the extensive investigation to rule out other possible diagnoses, magnetic resonance venogram revealed the final etiology of sixth nerve palsy that was ipsilateral left transverse sinus thrombosis; therefore, anticoagulant treatment with low molecular weight heparin was administered.
Rapid and accurate diagnosis and treatment cause to achieve excellent outcomes for most patients. Considering different clinical features, risk factors and high index of suspicion are helpful to reach the diagnosis.
脑静脉窦血栓形成的诊断仍然是一项真正的挑战。癫痫发作、突发的异常头痛、无法解释的持续性单侧血管性头痛以及难以归因于血管区域的神经功能缺损是一些提示性症状。
本文讨论了孤立性第六脑神经麻痹作为脑静脉血栓形成的一种罕见表现。在进行广泛检查以排除其他可能的诊断后，磁共振静脉造影显示第六脑神经麻痹的最终病因是同侧左横窦血栓形成；因此，给予了低分子量肝素抗凝治疗。
快速准确的诊断和治疗可使大多数患者获得良好的预后。考虑到不同的临床特征、危险因素以及高度的怀疑指数有助于做出诊断。
