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粟粒性颈淋巴结结核继发颈内静脉血栓形成所致颅内高压综合征:一例报告

Intracranial hypertension syndrome secondary to internal jugular vein thrombosis due to miliary cervical tuberculosis: A case report.

作者信息

Vega-Moreno Daniel Alejandro, Aviles-Aguilar Antonio, de la-Torre Abraham Ibarra, Aguilar-Calderón José Ramón, García-González Ulises, Santellán-Hernández José Omar, Betancourt-Quiroz Carlos, Dueñas-Espinoza Mario Alberto, González-González Ivan Eduardo, Molina-Martínez Rodolfo Pedro, Ochoa-Cacique Diego

机构信息

Department of Neurosurgery, Hospital Central Sur de Alta Especialidad, Mexico City, Mexico.

Department of Neurosurgery, Hospital Central Norte, PEMEX, Mexico City, Mexico.

出版信息

Surg Neurol Int. 2021 Jan 28;12:32. doi: 10.25259/SNI_885_2020. eCollection 2021.

Abstract

BACKGROUND

Thrombosis of the internal jugular vein (IJV) is extremely rare, being central catheterization the most common cause. We present a case of a patient with an unusual appearance of neurological symptoms as a consequence of thrombosis of the IJV secondary to miliary tuberculosis.

CASE DESCRIPTION

A 30-year-old woman with disseminated tuberculosis, with multiple lymphadenopathy, axillary, cervical, mesenteric, retroperitoneal, and inguinal, presented with clinical evidence of intracranial hypertension. A diagnostic cerebral angiography was performed, which revealed an occluded left internal jugular and venous stasis in the entire cerebral venous system. The patient was treated with low-molecular-weight heparin, with which she had an adequate evolution.

CONCLUSION

Tuberculosis is capable of generating a state of hypercoagulability, in addition to a mechanical compression effect due to cervical lymphadenopathy. We report an unusual clinical presentation, with intracranial involvement due to IJV thrombosis secondary to miliary tuberculosis. So far, there are no cases with a similar presentation described above.

摘要

背景

颈内静脉血栓形成极为罕见,中心静脉置管是最常见的原因。我们报告一例因粟粒性肺结核继发颈内静脉血栓形成而出现异常神经症状的患者。

病例描述

一名30岁播散性肺结核女性患者,有多处淋巴结肿大,包括腋窝、颈部、肠系膜、腹膜后和腹股沟淋巴结肿大,出现颅内高压的临床证据。进行了诊断性脑血管造影,结果显示左侧颈内静脉闭塞,整个脑静脉系统存在静脉淤滞。该患者接受了低分子量肝素治疗,病情进展良好。

结论

结核病除了因颈部淋巴结肿大产生机械压迫作用外,还能够引发高凝状态。我们报告了一例不寻常的临床表现,即粟粒性肺结核继发颈内静脉血栓形成导致颅内受累。迄今为止,尚无上述类似表现的病例报道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/7881519/4dc3471ac79a/SNI-12-32-g001.jpg

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