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以双眼失明和双侧感音神经性听力损失为表现的脑静脉血栓形成

Cerebral Venous Thrombosis Presenting With Binocular Blindness and Bilateral Sensorineural Hearing Loss.

作者信息

Llapitan Lhara Monique L, Gan Herminigildo H

机构信息

Department of Neurology, Jose R. Reyes Memorial Medical Center, Manila, PHL.

出版信息

Cureus. 2025 Feb 22;17(2):e79486. doi: 10.7759/cureus.79486. eCollection 2025 Feb.

Abstract

Cerebral venous thrombosis (CVT) is caused by occlusion of dural sinuses and cerebral and cerebellar veins. It is a rare type of stroke usually presenting with headache, seizure, and focal motor deficit. We report a case of a 27-year-old Asian female with no significant medical history but a four-year history of unsupervised use of oral contraceptives, who presented with a sudden-onset headache followed by a generalized tonic-clonic seizure. Neurologic examination revealed papilledema with light perception in both eyes, right lateral rectus palsy, and bilateral sensorineural hearing loss. Imaging studies showed a subacute convexal subarachnoid hemorrhage over the right parietal lobe and thrombosis in the posterior superior sagittal sinus. She was given levetiracetam for seizure control and dabigatran for anticoagulation. Upon discharge, her hearing loss and lateral rectus palsy had resolved; however, bilateral blindness persisted. This case highlights the importance of recognizing rare manifestations of cerebral venous thrombosis, such as bilateral blindness and sensorineural hearing loss. These symptoms can be overlooked due to the more common presentations of headache, seizure, and focal motor deficits.

摘要

脑静脉血栓形成(CVT)是由硬脑膜窦以及大脑和小脑静脉闭塞引起的。它是一种罕见的中风类型,通常表现为头痛、癫痫发作和局灶性运动功能缺损。我们报告一例27岁的亚洲女性病例,该患者无重大病史,但有四年无监管使用口服避孕药的历史,她突发头痛,随后出现全身性强直阵挛发作。神经系统检查发现双眼视乳头水肿伴光感、右侧外直肌麻痹和双侧感音神经性听力损失。影像学研究显示右顶叶有亚急性脑凸面蛛网膜下腔出血以及上矢状窦后部血栓形成。给予左乙拉西坦控制癫痫发作,并给予达比加群进行抗凝治疗。出院时,她的听力损失和外直肌麻痹已恢复;然而,双侧失明仍然存在。该病例强调了认识脑静脉血栓形成罕见表现的重要性,如双侧失明和感音神经性听力损失。由于头痛、癫痫发作和局灶性运动功能缺损等更常见的表现,这些症状可能会被忽视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2713/11933856/649ece048ed8/cureus-0017-00000079486-i01.jpg

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