Fukudome T, Shirabe S, Yoshimura T, Tsujihata M, Nagataki S
First Department of Internal Medicine, Nagasaki University School of Medicine.
Rinsho Shinkeigaku. 1994 Jun;34(6):587-9.
A 33-year-old man with a 13-year history of ulcerative colitis developed generalized clonic convulsions after transient right hemiparesis. A computed tomographic scan revealed a hemorrhagic lesion in the left frontal lobe and contrast tomography demonstrated delta-sign in the occipital area. A sagittal gadolinium-contrast magnetic resonance imaging scan demonstrated a low signal intensity area in the superior sagittal sinus. The venous phase of his carotid angiogram showed a lack of filling of the superior sagittal sinus. Coagulation studies revealed abnormal findings, elevated fibrinogen and increased aggregation of platelets. Cerebral venous or sagittal thrombosis occurring in ulcerative colitis is very rare in Japan. But thromboembolism is known as one of the extraintestinal complications of ulcerative colitis, and a hypercoagulable state may occur even in the inactive state. Ulcerative colitis should be considered as one of the etiologies of thromboembolism in addition to the results of coagulation studies for the prevention of cerebrovascular diseases.
一名患有13年溃疡性结肠炎病史的33岁男性，在短暂性右侧偏瘫后出现全身性阵挛性惊厥。计算机断层扫描显示左额叶有出血性病变，对比断层扫描显示枕叶区域有δ征。矢状位钆对比磁共振成像扫描显示上矢状窦有低信号强度区域。他的颈动脉血管造影静脉期显示上矢状窦充盈缺损。凝血研究结果异常，纤维蛋白原升高，血小板聚集增加。在日本，溃疡性结肠炎并发脑静脉或矢状窦血栓形成非常罕见。但血栓栓塞是溃疡性结肠炎已知的肠外并发症之一，即使在疾病静止期也可能出现高凝状态。除了凝血研究结果外，为预防脑血管疾病，溃疡性结肠炎也应被视为血栓栓塞的病因之一。
