Adachi T, Takagi M, Hoshino H, Aki T, Onozuka S
Department of neurology, Tokyo Saiseikai Central Hospital.
Rinsho Shinkeigaku. 1996 Nov;36(11):1234-9.
A 45-year-old man was admitted to our hospital because of generalized seizure. He had epilepsy and mental retardation since age of two. On admission temperature was 37.9 degrees C but, nuchal rigidity and Kernig's sign were not present. There were no other abnormal findings on physical examination. Neurological examination revealed consciousness disturbance, generalized seizure and mental retardation. Right hemiparesis gradually developed after generalized seizure. Laboratory data did not show any abnormalites to induce cerebral venous thrombosis. A brain MRI revealed hyperintensity on T2-weighted images and slightly enhanced on T1-weighted images in the left frontal lobe, using Gd-DTPA. An increased signal was also noted in the superior sagittal sinus on T1-weighted images. The superior sagittal sinus was patent but the cortical vein in the left frontal lobe was not demonstrated on cerebral angiography. A diagnosis of an isolated cortical vein thrombosis was made by exploratory craniotomy. Anticoagulation with heparin was started. Although the cortical vein thrombosis usually co-exsists with dural sinus thrombosis, an isolated cortical vein thrombosis like this case was rather rare. A case with cerebral venous thrombosis localized only in the left frontal cortical vein is reported, but definitive etiology is not known.
一名45岁男性因全身性癫痫发作入院。他自两岁起患有癫痫和智力发育迟缓。入院时体温为37.9摄氏度，但无颈项强直和克氏征。体格检查无其他异常发现。神经学检查显示意识障碍、全身性癫痫发作和智力发育迟缓。全身性癫痫发作后逐渐出现右侧偏瘫。实验室检查数据未显示任何可诱发脑静脉血栓形成的异常情况。脑部MRI显示，使用钆喷酸葡胺后，左侧额叶在T2加权图像上呈高信号，在T1加权图像上略有强化。T1加权图像上矢状窦也可见信号增强。上矢状窦通畅，但脑血管造影未显示左侧额叶的皮质静脉。通过开颅探查诊断为孤立性皮质静脉血栓形成。开始使用肝素进行抗凝治疗。虽然皮质静脉血栓形成通常与硬脑膜窦血栓形成并存，但像本病例这样的孤立性皮质静脉血栓形成相当罕见。本文报道了一例仅局限于左侧额叶皮质静脉的脑静脉血栓形成病例，但确切病因尚不清楚。
