Egashira Shuhei, Yoshimoto Takeshi, Tanaka Kanta, Kamogawa Naruhiko, Shiozawa Masayuki, Koge Junpei, Toyoda Kazunori, Koga Masatoshi
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Department of Neurology, National Cerebral and Cardiovascular Center.
Rinsho Shinkeigaku. 2022 Dec 17;62(12):928-934. doi: 10.5692/clinicalneurol.cn-001788. Epub 2022 Nov 29.
A 57-year-old man presented with headache, transient right upper extremity weakness and numbness one month after recovery from coronavirus disease 2019 (COVID-19). His medical history included Graves' disease and IgG4-related ophthalmic disease. He had been administered prednisolone. His weakness and numbness were transient and not present on admission. Contrast-enhanced CT and MRI of the head showed thrombi in the superior sagittal sinus, right transverse sinus, sigmoid sinus, and the right internal jugular vein. Digital subtraction angiography showed occlusion at the same sites and mild perfusion delay in the left frontoparietal lobe. We diagnosed the patient with cerebral venous sinus thrombosis and treated him with anticoagulation. The thrombi partially regressed three months later, and perfusion delay became less noticeable. Cerebral venous sinus thrombosis is an important complication of COVID-19. Patients with predisposing factors, including Graves' disease and IgG4-related ophthalmic disease, may be at increased risk of developing cerebral venous sinus thrombosis even after recovery from COVID-19.
一名57岁男性在新型冠状病毒肺炎(COVID-19)康复1个月后出现头痛、右上肢短暂性无力和麻木。他的病史包括格雷夫斯病和IgG4相关性眼病,曾接受泼尼松龙治疗。他的无力和麻木是短暂性的,入院时已不存在。头颅增强CT和MRI显示上矢状窦、右侧横窦、乙状窦及右侧颈内静脉内有血栓形成。数字减影血管造影显示相同部位闭塞,左侧额顶叶有轻度灌注延迟。我们诊断该患者为脑静脉窦血栓形成,并给予抗凝治疗。3个月后血栓部分消退,灌注延迟也不那么明显了。脑静脉窦血栓形成是COVID-19的一种重要并发症。有包括格雷夫斯病和IgG4相关性眼病等易感因素的患者,即使在COVID-19康复后,发生脑静脉窦血栓形成的风险也可能增加。