Imai Takeshi, Ohsima Jun, Hasegawa Yasuhiro
Department of Internal Medicine, Division of Neurology, St Marianna University School of Medicine, Yokohama City Seibu Hospital.
Department of Internal Medicine, Division of Neurology, St Marianna University School of Medicine.
Rinsho Shinkeigaku. 2018 Nov 28;58(11):696-699. doi: 10.5692/clinicalneurol.cn-001212. Epub 2018 Oct 27.
A 71-year-old male with no previous medical history was admitted to our hospital for paralysis of the right upper extremity. Although DWI of the brain revealed high-intensity signals in the bilateral frontal and left parietal lobes, CT revealed a hyperdense spot in the anterior superior sagittal sinus (SSS). Because CT venography revealed SSS occlusion, he was diagnosed with cerebral venous thrombosis (CVT). In addition, laboratory findings, including free triiodothyronine, 8.85 pg/ml; thyroxine, 3.39 pg/dl, thyroid-stimulating hormone (TSH), < 0.02 μU/ml; and anti-TSH receptor antibody, 5.7 IU/l, led to the diagnosis of hyperthyroidism for the first time. Moreover, factor VIII procoagulant protein levels exhibited a marked increase (187.5%). Based on these findings, the patient was diagnosed with CVT due to Graves' disease.
一名71岁无既往病史的男性因右上肢麻痹入住我院。尽管脑部弥散加权成像（DWI）显示双侧额叶和左侧顶叶有高强度信号，但计算机断层扫描（CT）显示上矢状窦（SSS）前部有一个高密度点。由于CT静脉造影显示SSS闭塞，他被诊断为脑静脉血栓形成（CVT）。此外，实验室检查结果，包括游离三碘甲状腺原氨酸8.85 pg/ml、甲状腺素3.39 pg/dl、促甲状腺激素（TSH）<0.02 μU/ml和抗TSH受体抗体5.7 IU/l，首次诊断为甲状腺功能亢进。此外，凝血因子VIII促凝蛋白水平显著升高（187.5%）。基于这些发现，该患者被诊断为格雷夫斯病所致的CVT。
