Nagai S, Horie Y, Akai T, Takeda S, Takaku A
Department of Neurosurgery, Saiseikai Toyama Hospital, Japan.
Neurol Med Chir (Tokyo). 1998 Jan;38(1):34-9. doi: 10.2176/nmc.38.34.
A 36-year-old female with a history of recurrent pregnancy loss experienced sudden onset of disturbance in consciousness, with right hemiparesis and total aphasia. Computed tomography revealed a massive hemorrhage in the left frontal lobe, and angiography showed occlusion of the anterior two-thirds of the superior sagittal sinus. Laboratory investigations detected the presence of lupus anticoagulant, elevation of the anticardiolipin beta 2-glycoprotein I complex antibody level, and a decreased protein S activity level. There were no underlying conditions, such as connective tissue disorders, malignancies, infectious diseases, and drug-induced disorders, so the diagnosis was primary antiphospholipid syndrome. Primary antiphospholipid syndrome should be considered in the evaluation of patients with "idiopathic" or "primary" sinus and cerebral venous thrombosis.
一名有复发性流产病史的36岁女性突然出现意识障碍,伴有右侧偏瘫和完全性失语。计算机断层扫描显示左额叶大量出血,血管造影显示上矢状窦前三分之二闭塞。实验室检查发现存在狼疮抗凝物,抗心磷脂β2-糖蛋白I复合物抗体水平升高,蛋白S活性水平降低。不存在结缔组织疾病、恶性肿瘤、传染病和药物性疾病等基础疾病,因此诊断为原发性抗磷脂综合征。在评估“特发性”或“原发性”窦和脑静脉血栓形成的患者时,应考虑原发性抗磷脂综合征。