Ennis Giovana, Domingues Nelson, Silva Marques Joana, Ribeiro Pedro, Andrade Cristina
Department of Internal Medicine, Centro Hospitalar Tondela-Viseu, Viseu, PRT.
Cureus. 2021 Apr 29;13(4):e14750. doi: 10.7759/cureus.14750.
Cerebral venous thrombosis (CVT) is a serious medical condition which is difficult to diagnose because of its wide range of clinical presentations. The symptoms can vary from an isolated headache to coma. Here, we present the case of a 76-year-old female patient with a history of immune thrombocytopenic purpura, arterial hypertension, and pulmonary embolism. The diagnosis of CVT was challenging because the initial form of disease presentation mimicked a transient ischemic attack (transient aphasia and right hemiparesis). Therapeutical decisions were also a challenge because, at the time of the diagnosis, the patient was suffering from severe thrombocytopenia (29 × 10/L), which had to be taken into account. After multidisciplinary discussions, therapeutic subcutaneous enoxaparin was started, resulting in a progressive and significant neurological recovery. In presenting this case, our primary goal is to point out that CVT can be difficult to diagnose because of its wide range of clinical presentations. Headache (a symptom that was never present in this case) is the most frequent complaint, occurring in 90% of cases. Following diagnosis, an etiological study is required.
脑静脉血栓形成（CVT）是一种严重的疾病，由于其临床表现多样，难以诊断。症状从单纯头痛到昏迷不等。在此，我们报告一例76岁女性患者，有免疫性血小板减少性紫癜、动脉高血压和肺栓塞病史。CVT的诊断具有挑战性，因为疾病最初的表现形式类似短暂性脑缺血发作（短暂性失语和右侧偏瘫）。治疗决策也颇具挑战，因为在诊断时，患者患有严重血小板减少症（29×10/L），这一点必须予以考虑。经过多学科讨论后，开始皮下注射治疗性依诺肝素，患者神经功能逐渐显著恢复。在呈现这个病例时，我们的主要目的是指出，由于CVT临床表现多样，可能难以诊断。头痛（本病例中从未出现过的症状）是最常见的主诉，90%的病例会出现。诊断后，需要进行病因学研究。
