Department of Neurology, Renai Medicity Multi Super Speciality Hospital, Kochi, Kerala, India.
Department of Radiology, Renai Medicity Multi Super Speciality Hospital, Kochi, Kerala, India.
Ann Afr Med. 2024 Jul 1;23(3):496-500. doi: 10.4103/aam.aam_138_23. Epub 2024 Jul 20.
The etiology of cerebral venous sinus thrombosis (CVST) is multifactorial. Although many acquired and genetic factors have been recognized as risk factors, hyperhomocysteinemia (hHcy) is independently associated with CVST. We describe three cases of CVST in this case series. All of them presented with headache. Two patients had papilledema and visual disturbances. On evaluation, there was CVST, and prothrombotic workup showed hHcy. In addition, two of them reported very low Vitamin B12 levels. All of them were treated with low-molecular-weight heparin followed by oral anticoagulation and Vitamin B6, B9, and B12 supplements. All of them responded to treatment, and follow-up imaging studies in two of them showed resolution of thrombosis. hHcy should be considered in the evaluation of CVST, especially in the setting of a pure vegetarian diet. Fortification of the diet with Vitamin B12 may be considered the majority of Indians consume predominantly vegetarian food.
脑静脉窦血栓形成（CVST）的病因是多因素的。尽管许多获得性和遗传性因素已被认为是危险因素，但高同型半胱氨酸血症（hHcy）与 CVST 独立相关。我们在本病例系列中描述了三例 CVST 病例。他们都表现为头痛。两名患者有视乳头水肿和视力障碍。评估时，发现存在 CVST，血栓形成前的检查显示 hHcy。此外，其中两人报告维生素 B12 水平非常低。他们均接受低分子量肝素治疗，随后进行口服抗凝和维生素 B6、B9 和 B12 补充治疗。他们都对治疗有反应，其中两名患者的随访影像学研究显示血栓溶解。hHcy 应在 CVST 的评估中考虑，特别是在纯素食饮食的情况下。考虑到大多数印度人主要食用素食，应在饮食中强化维生素 B12。
