Xu Yongfeng, Qiu Minjian
Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Front Neurol. 2021 Feb 23;12:642088. doi: 10.3389/fneur.2021.642088. eCollection 2021.
Behçet disease (BD) is an autoimmune and vasculitic disorder. BD affects the veins more frequently than the arteries. The cerebral venous sinus thrombosis (CVST) was reported to occur in about 20% of neuro-BD. Huge dilemma exists in the treatment of CVST with BD, some of which were refractory to the standard therapy. Here, we report a BD case with refractory intracranial hypertension caused by CVST which is successfully treated with catheter-directed endovascular thrombolysis. Before endovascular thrombolysis, intravenous pulse methylprednisolone combined with anticoagulant therapy was used, and resulted in limited effects. We conclude that catheter-directed thrombolysis may be considered for refractory CVST with BD, provided that coexistent pulmonary and cerebral artery aneurysms are ruled out.
白塞病（BD）是一种自身免疫性血管炎疾病。BD累及静脉比动脉更为常见。据报道，约20%的神经白塞病患者会发生脑静脉窦血栓形成（CVST）。白塞病合并CVST的治疗存在巨大困境，其中一些对标准治疗无效。在此，我们报告1例由CVST导致难治性颅内高压的白塞病病例，该病例通过导管定向血管内溶栓成功治疗。在血管内溶栓前，使用了静脉注射甲泼尼龙冲击联合抗凝治疗，但效果有限。我们得出结论，对于白塞病合并难治性CVST，在排除并存的肺和脑动脉瘤的情况下，可考虑采用导管定向溶栓治疗。
