Hashmi Ariba, Kim Paul, Ahmad Syed W, Faucheux Jason, Gandikal Naz
Medical Education, Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Family Medicine, Advent Health Orlando, Orlando, USA.
Cureus. 2019 Aug 26;11(8):e5491. doi: 10.7759/cureus.5491.
Cerebral venous sinus thrombosis is a challenging diagnosis due in part to its variable clinical presentation and rarity. The annual incidence ranges from 0.22 to 1.57 per 100,000. The etiology of such disease is related to hypercoagulability states. Although illicit androgen use is a well-known cause of prothrombotic states, its risk of causing cerebral venous sinus thrombosis has been infrequently reported. We present the case of a 33-year-old male with no known past medical history who presented to the emergency department (ED) with persistent seizure activity, neurological deficits, and history of worsening headaches who was found to have an extensive superior sagittal sinus thrombosis on imaging. Radiologic findings demonstrated pathognomonic findings of cord sign and delta sign, the previous being highly specific but of low incidence. An inconclusive hypercoagulability workup prompted further questioning which revealed illicit androgenic anabolic steroid use. Prompt treatment with anticoagulation and anti-seizure medication was pursued with full resolution of his neurologic symptomatology.
脑静脉窦血栓形成是一种具有挑战性的诊断，部分原因在于其临床表现多样且罕见。年发病率为每10万人0.22至1.57例。此类疾病的病因与高凝状态有关。虽然非法使用雄激素是众所周知的血栓形成前状态的原因，但其导致脑静脉窦血栓形成的风险鲜有报道。我们报告一例33岁男性病例，该患者既往无已知病史，因持续性癫痫发作、神经功能缺损和头痛加重病史就诊于急诊科，影像学检查发现广泛的上矢状窦血栓形成。放射学检查结果显示了具有诊断意义的条索征和三角征，前者特异性高但发生率低。一项未得出结论的高凝检查促使进一步询问，结果发现其非法使用雄激素类合成代谢类固醇。给予抗凝和抗癫痫药物及时治疗后，其神经症状完全缓解。
