Kapur Vinay, D'Cruz Sanjay, Kaur Ravinder
Department of General Medicine, Dr HS Judge Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India.
Department of General Medicine, Government Medical College & Hospital, Chandigarh, India.
J Med Case Rep. 2019 Feb 18;13(1):36. doi: 10.1186/s13256-019-1988-9.
Cerebral venous thrombosis is relatively rare and characterized by a wide spectrum of clinical features. It is more common in young adults with women affected more than men. The diagnosis of cerebral venous thrombosis is easier nowadays due to easy access to advanced neuroimaging techniques. Abnormalities in thrombophilic profile are associated with enhanced risk of cerebral venous thrombosis. It has varied etiologies such as hypercoagulable states, infection, dehydration, pregnancy, and substance abuse. Hyperhomocysteinemia is found to be closely associated with an enhanced risk of cerebral venous thrombosis.
Here we report a case of cerebral venous thrombosis secondary to hyperhomocysteinemia caused by vitamin B deficiency in a 32-year-old Indo-Aryan man. A detailed coagulation workup led us to find the etiology of cerebral venous thrombosis in this patient who followed a strict vegetarian diet and had vitamin B deficiency leading to hyperhomocysteinemia.
There are conflicting reports in the literature about the association of hyperhomocysteinemia, B deficiency, and cerebral venous thrombosis but some reports point to a significant association. We conclude that further studies with a large sample size are required to analyze the effect of hyperhomocysteinemia and low vitamin B on the risk of cerebral venous thrombosis.
脑静脉血栓形成相对罕见，具有广泛的临床特征。在年轻人中更为常见，女性比男性更易受影响。由于先进神经影像学技术的广泛应用，如今脑静脉血栓形成的诊断更加容易。血栓形成倾向的异常与脑静脉血栓形成风险增加相关。其病因多样，如高凝状态、感染、脱水、妊娠和药物滥用。高同型半胱氨酸血症被发现与脑静脉血栓形成风险增加密切相关。
在此，我们报告一例32岁印度 - 雅利安男性因维生素B缺乏导致高同型半胱氨酸血症继发脑静脉血栓形成的病例。详细的凝血检查使我们找到了该患者脑静脉血栓形成的病因，该患者遵循严格的素食饮食且存在维生素B缺乏，导致高同型半胱氨酸血症。
关于高同型半胱氨酸血症、维生素B缺乏与脑静脉血栓形成之间的关联，文献中有相互矛盾的报道，但一些报道指出存在显著关联。我们得出结论，需要进行更大样本量的进一步研究，以分析高同型半胱氨酸血症和低维生素B对脑静脉血栓形成风险的影响。
