Mandai K, Tamaki N, Kurata H, Fukada Y, Iijima I, Nakamura H
Department of Neurosurgery, Kobe University School of Medicine.
No Shinkei Geka. 1997 Dec;25(12):1101-3.
A case of intracranial hemorrhage due to superior sagittal sinus thrombosis occurring in a boy with nephrotic syndrome is described. A twelve-year-old boy with nephrotic syndrome presented sudden onset of generalized convulsions. CT scan revealed a subcortical hematoma in the left frontal lobe. A left carotid angiography revealed the occlusion of the superior sagittal sinus. Neurological findings included disturbance of consciousness, right hemiparesis, and motor aphasia after the convulsions. All symptoms and signs disappeared immediately. There has been no evidence of rebleeding or convulsions for the last two years. This case had no abnormality of the coagulation system in routine investigation, but nephrotic syndrome and steroid therapy appeared to be associated with several disorders of the coagulation system. The authors suggested that it was necessary to pay attention to possible intracranial hemorrhage caused by cerebral venous sinus thrombosis in patients with nephrotic syndrome or who had undergone steroid therapy.
本文描述了一名患有肾病综合征的男孩因上矢状窦血栓形成导致颅内出血的病例。一名12岁患有肾病综合征的男孩突然出现全身性惊厥。CT扫描显示左额叶皮质下血肿。左颈动脉血管造影显示上矢状窦闭塞。神经系统检查结果包括惊厥后意识障碍、右侧偏瘫和运动性失语。所有症状和体征立即消失。在过去两年中没有再出血或惊厥的证据。该病例在常规检查中凝血系统无异常,但肾病综合征和类固醇治疗似乎与几种凝血系统紊乱有关。作者建议,对于患有肾病综合征或接受过类固醇治疗的患者,有必要注意脑静脉窦血栓形成可能导致的颅内出血。