MacIntosh Peter W, Lin Amy Y, Kim Jin Suh, Testai Fernando D, Moss Heather E
Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA.
Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA.
Neuroophthalmology. 2017 May 8;41(5):284-286. doi: 10.1080/01658107.2017.1308520. eCollection 2017 Oct.
A 60-year-old woman with history of multiple myeloma was in remission after stem cell transplant 6 years prior. She was undergoing work-up for headaches that were thought to be secondary to a right mastoiditis seen on magnetic resonance imaging (MRI). On routine eye exam, papilloedema was noted. A lumbar puncture was performed, with elevated opening pressure with normal constituents. She was an atypical age for idiopathic intracranial hypertension, and her mastoiditis raised concern for secondary cerebral venous sinus thrombosis. Magnetic resonance venography (MRV) was performed showing poor flow in the right sigmoid sinus, and computed tomography venography (CTV) showed lack of contrast enhancement distal to the right sigmoid sinus, consistent with occlusion. There was also an enhancing mass inferior to the right occipital bone. Biopsy confirmed recurrent plasma cell myeloma. She was treated with chemotherapy, radiation, and warfarin for presumed cerebral venous sinus thrombosis.
一名60岁有多发性骨髓瘤病史的女性，6年前干细胞移植后处于缓解期。她因头痛接受检查，磁共振成像（MRI）显示右侧乳突炎，认为头痛与此有关。常规眼科检查发现视乳头水肿。进行了腰椎穿刺，初压升高但成分正常。她患特发性颅内高压的年龄不典型，且其乳突炎引发了对继发性脑静脉窦血栓形成的担忧。进行了磁共振静脉血管造影（MRV），显示右侧乙状窦血流不佳，计算机断层扫描静脉血管造影（CTV）显示右侧乙状窦远端缺乏造影剂增强，符合闭塞表现。右侧枕骨下方还有一个强化肿块。活检证实为复发性浆细胞骨髓瘤。她接受了化疗、放疗，并因疑似脑静脉窦血栓形成接受了华法林治疗。
