Ntantos Dimitrios, Karantali Eleni, Prevezianou Angeliki, Angelopoulos Petros, Bostantjopoulou Sevasti
3rd Neurological Department of Aristotle, University of Thessaloniki - General Hospital "G. Papanikolaou", Exohi 57010, Thessaloniki, Greece.
3rd Neurological Department of Aristotle, University of Thessaloniki - General Hospital "G. Papanikolaou", Exohi 57010, Thessaloniki, Greece.
J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105244. doi: 10.1016/j.jstrokecerebrovasdis.2020.105244. Epub 2020 Aug 29.
Intracerebral haemorrhage in patients suffering from cerebral venous thrombosis (CVT) is relatively uncommon. CVT typically occurs in hypercoagulable state of various causes. Some drugs play a causative role in CVT and thrombopoietin receptor agonists are among them.
We present a female patient with refractory immune thrombocytopenic purpura (ITP) treated with romiplostim, suffering from severe thrombosis of jugular vein expanding intracranially. Despite being treated with adequate anticoagulation, she developed spontaneous bilateral epidural and subdural hematomas with devastating outcome.
To our knowledge, this is the first reported case of spontaneous atraumatic epidural hematomas due to CVT in adult patient. We support that in our patient, blood stasis leading to the dissection of dura mater, platelet dysfunction, and anticoagulation treatment contributed to the formation of the intracranial, extracerebral haemorrhages.
患有脑静脉血栓形成（CVT）的患者发生脑出血相对少见。CVT通常发生在各种原因导致的高凝状态下。一些药物在CVT中起致病作用，血小板生成素受体激动剂就是其中之一。
我们报告一名患有难治性免疫性血小板减少性紫癜（ITP）的女性患者，接受罗米司亭治疗，发生了严重的颈静脉血栓形成并向颅内扩展。尽管接受了充分的抗凝治疗，她仍出现了自发性双侧硬膜外和硬膜下血肿，预后极差。
据我们所知，这是首例报道的成年患者因CVT导致自发性非创伤性硬膜外血肿的病例。我们认为，在我们的患者中，血液淤滞导致硬脑膜剥离、血小板功能障碍以及抗凝治疗促成了颅内、脑外出血的形成。
