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蛇咬伤所致脑静脉窦血栓形成:一例报告

Snakebite Induced Cerebral Venous Sinus Thrombosis: A Case Report.

作者信息

Yousaf Muhammad, Khan Qaisar Ali, Anthony Michelle R, Badshah Aliena, Abdi Parsa, Farkouh Christopher, Hadi Faiza Amatul, Jan Rukhsar, Khan Arooba, Iram Sumaira

机构信息

Khyber Teaching Hospital MTI KTH, Peshawar, Pakistan.

University of Arizona College of Medicine, Tucson, AZ, USA.

出版信息

Clin Med Insights Case Rep. 2023 Apr 3;16:11795476231165750. doi: 10.1177/11795476231165750. eCollection 2023.

Abstract

INTRODUCTION

Cerebral venous sinus thrombosis (CVST) is a rare but highly fatal neurological condition mostly caused by prothrombotic conditions like antiphospholipid syndrome, factor V Leiden, and G20210A prothrombin polymorphism. Snake bites are a rare cause of cerebral venous sinus thrombosis that must be recognized and treated promptly to improve survival.

CASE PRESENTATION

We present a case of a 25-year-old male who developed headaches and seizures following a Viper snake bite. The diagnosis was made based on a magnetic resonance venogram (MRV) showing transverse sinus thrombosis with sigmoid sinus stenosis. Initially, the patient was treated with antivenom and supportive treatment for disseminated intravascular coagulation (DIC). After the diagnosis of CVST, the patient was treated with rivaroxaban and levetiracetam. The patient improved within 1 week of treatment and was advised to follow up in 3 months.

CONCLUSION

A high index of suspicion for cerebral venous sinus thrombosis is required if the patient presents with headaches, seizures, or abnormal vision following a snake bite. Early diagnosis and management can prevent further neurological damage.

摘要

引言

脑静脉窦血栓形成(CVST)是一种罕见但致命性很高的神经系统疾病,主要由抗磷脂综合征、凝血因子V莱顿突变和凝血酶原G20210A多态性等促血栓形成状况引起。蛇咬伤是脑静脉窦血栓形成的一种罕见病因,必须予以识别并迅速治疗以提高生存率。

病例报告

我们报告一例25岁男性,在被蝰蛇咬伤后出现头痛和癫痫发作。诊断基于磁共振静脉血管造影(MRV)显示横窦血栓形成伴乙状窦狭窄。最初,患者接受了抗蛇毒血清治疗以及针对弥散性血管内凝血(DIC)的支持治疗。在诊断为CVST后,患者接受了利伐沙班和左乙拉西坦治疗。患者在治疗1周内病情好转,并被建议在3个月后进行随访。

结论

如果患者在蛇咬伤后出现头痛、癫痫发作或视力异常,需要高度怀疑脑静脉窦血栓形成。早期诊断和治疗可预防进一步的神经损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e55f/10074634/9030c1221466/10.1177_11795476231165750-fig1.jpg

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