Shimizu Yu, Tsuchiya Katsuhiro, Fujisawa Hironori
Department of Neurosurgery, Kanazawa Medical Center, Kanazawa, Japan.
Department of Neurosurgery, Kanazawa Medical Center, Kanazawa, Japan.
J Stroke Cerebrovasc Dis. 2019 May;28(5):e39-e43. doi: 10.1016/j.jstrokecerebrovasdis.2019.01.023. Epub 2019 Feb 14.
Cerebral venous thrombosis is rare and an uncommon cause of stroke and has diverse etiologies and varied clinical presentations. Here, we report 2 cases of deep cerebral venous thrombosis.
A 64-year-old woman presented with cerebral venous thrombosis due to a hypercoagulable state associated with ovarian tumor. On initial fluid-attenuated inversion recovery and diffusion-weighted imaging, there was a diffuse high-intensity lesion in the bilateral thalamus. Computed tomography angiography showed occlusion of the straight sinus, vein of Galen, and internal cerebral vein. Single-photon emission computed tomography showed decreased cerebral blood flow in the bilateral thalamus. After 3 weeks of factor Xa inhibitor therapy, the patient's consciousness gradually improved and eventually became clear enough to leave the hospital. She had no neurological deficit. Another patient was a 47-year-old man who presented with splitting headache and drowsiness. Magnetic resonance venography confirmed deep thrombosis of the vein of Galen. He completely recovered after 4 weeks of factor Xa inhibitor therapy.
This study reports on 2 rare cases of decreased cerebral blood flow in the bilateral thalamus on single-photon emission computed tomography, which improved following the administration of factor Xa inhibitor.
脑静脉血栓形成较为罕见，是一种不常见的卒中病因，病因多样，临床表现各异。在此，我们报告2例大脑深部静脉血栓形成病例。
一名64岁女性因与卵巢肿瘤相关的高凝状态而出现脑静脉血栓形成。在最初的液体衰减反转恢复序列和扩散加权成像上，双侧丘脑出现弥漫性高强度病变。计算机断层血管造影显示直窦、大脑大静脉和大脑内静脉闭塞。单光子发射计算机断层扫描显示双侧丘脑脑血流量减少。在接受3周的Xa因子抑制剂治疗后，患者意识逐渐改善，最终清醒到足以出院。她没有神经功能缺损。另一名患者是一名47岁男性，表现为头痛欲裂和嗜睡。磁共振静脉造影证实大脑大静脉深部血栓形成。在接受4周的Xa因子抑制剂治疗后，他完全康复。
本研究报告了2例单光子发射计算机断层扫描显示双侧丘脑脑血流量减少的罕见病例，在给予Xa因子抑制剂后病情有所改善。
