Öz
Cerebral venous sinus thrombosis VST is a rare condition. Patients with cerebral venous thrombosis CVT may present with headache, cranial nerve palsies, focal neurological deficits, seizure and decreased level of consciousness. A previously healthy 32-year-old man presented to the emergency room with headache, paralysis and homonymous hemianopsia. A cranial MRI study was obtained and gradient-echo T2 weighted image GRE findings demonstrated pathological hypointensities in the transvers sinus, juguler vein and venous structures inside the paranchyme. VST was diagnosed based on the findings of GRE sequence and diagnosis was confirmed on non-contrast TOF-MR venography. The patient was anticoagulated with heparin. Over the next 2 days, the severity of the headache decreased, warfarin therapy was initiated, and the heparin infusion was tapered. A week later, his headache and neurological deficits disappeared completely. The GRE sequence imaging may provide useful knowledge in patient with VST
Anahtar Kelimeler
Kaynakça
- Daif A, Awada A, al-Rajeh S, et al. Cerebral venous thrombosis in adults. A study of 40 cas es from Saudi Arabia. Stroke. 1995;26(7):1193-5.
- Buccino G, Scoditti U, Patteri I, et al. Neurological and cognitive long-term outcome in patients with cerebral venous sinus thrombosis. Acta Neurol Scand. 2003;107(5):330-5.
- Ameri A, Bousser MG. Cerebral venous thrombosis. Neurol Clin. 1992;10(1):87-111.
- Flores-Barragan JM, Hernandez-Gonzalez A, Gallardo-Alcaniz MJ, Del Real-Francia MA, Vaamonde-Gamo J. [Clinical and therapeutic heterogeneity of cerebral venous thrombosis: a description of a series of 20 cases.]. Rev Neurol. 2009;49(11):573-6.
- Ozsvath RR, Casey SO, Lustrin ES, et al. Cerebral venography: comparison of CT and MR projection venography. AJR Am J Roentgenol. 1997;169(6):1699- 707.
- Vogl T, Bergman C, Villringer A, Einhaupal K, Lissner J, Felix R. Dural sinus thrombosis: value of venous MRA for diagnosis and follow up. Am J Radiology 1994; 162:1191-8.
- Chen WL, Chang SH, Chen JH, Wu YL. Isolated headache as the sole manifestation of dural sinus thrombosis: a case report with literature review. Am J Emerg Med. 2007;25(2):218-9.
- Leach JL, Strub WM, Gaskill-Shipley MF. Cerebral venous thrombus signal intensity and susceptibility eff ects on gradient recalled-echo MR imaging. AJNR Am J Neuroradiol. 2007;28(5):940-5.
- Schellinger PD, Chalela JA, Kang DW, et al. Diagnostic and prognostic value of early MR imaging vessel sign in hyperacute stroke patients imaged
- Wintermark M, Albers GW, Alexandrov AV, Alger JR, Bammer R, Baron JC, et al. Acute stroke imaging research roadmap. AJNR Am J Neuroradiol. 2008;29(5):e23-30.
- Reichenbach JR, Venkatesan R, Schillinger DJ, et al. Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology 1997;204(1):272-77.
- Ogawa S, Lee TM, Kay AR, et al. Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci USA 1990;87:9868-72.
- Edelman RR, Johnson K, Buxton R, Shoukimas G, Rosen BR, Davis KR, Brady TJ. MR of hemorrhage: a new approach. AJNR Am J Neuroradiol. 1986;7(5):751-6.
- Kidwell CS, Chalela JA, Saver JL, et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA 2004;292:1823-1830.
- Fiebach JB, Schellinger PD, Gass A, Kucinski T, Siebler M, Villringer A, et al. Stroke magnetic resonance imaging is accurate in hyperacute intracerebral hemorrhage: a multicenter study on the validity of stroke imaging. Stroke. 2004;35(2):502-6.
- Kaya D, Dinçer A, Yildiz ME, Cizmeli MO, Erzen C. Acute ischemic infarction defi ned by a region of multiple hypointense vessels on gradient-echo T2* MR imaging at 3T. AJNR Am J Neuroradiol. 2009;30(6):1227-32.
- Ameri A, Bousser MG. Cerebral venous sinus thrombosis. Neurol Clin. 1992;10:87-11.
Öz
Venöz sinüs trombozu nadir görülen bir hastalıktır. Hastalar başağrısı, kraniyal sinir tutulumu, fokal nörolojik defisit, epileptik atak ve bilinç bulanıklığı ile başvurabilir. Daha önce hiçbir sağlık problemi olmayan 32 yaşındaki erkek hasta başağrısı, sol tarafta belirgin iki taraflı kuvvet kaybı ve sol homonim hemianopsi kliniği ile acil servise başvurdu. Kranial MR görüntülemede, gradient eko T2* GRE sekans görüntülerde transvers sinüste, juguler vende ve parankim içi venöz yapılarda belirgin hipointensite gözlendi. GRE bulgularına göre hastada VST tanısı düşünüldü ve tanı kontrastsız TOF MR-venografi ile doğrulandı. Hasta önce heparin ile antikoagüle edildi, 2 gün içinde başağrısı azaldı, daha sonra tedaviye warfarin ile devam edildi. Bir hafta sonra başağrısı ve nörolojik defisit tamamen düzeldi. VST tanısında MRG’de GRE sekansı önemli bilgiler sağlayabilir
Anahtar Kelimeler
Kaynakça
- Daif A, Awada A, al-Rajeh S, et al. Cerebral venous thrombosis in adults. A study of 40 cas es from Saudi Arabia. Stroke. 1995;26(7):1193-5.
- Buccino G, Scoditti U, Patteri I, et al. Neurological and cognitive long-term outcome in patients with cerebral venous sinus thrombosis. Acta Neurol Scand. 2003;107(5):330-5.
- Ameri A, Bousser MG. Cerebral venous thrombosis. Neurol Clin. 1992;10(1):87-111.
- Flores-Barragan JM, Hernandez-Gonzalez A, Gallardo-Alcaniz MJ, Del Real-Francia MA, Vaamonde-Gamo J. [Clinical and therapeutic heterogeneity of cerebral venous thrombosis: a description of a series of 20 cases.]. Rev Neurol. 2009;49(11):573-6.
- Ozsvath RR, Casey SO, Lustrin ES, et al. Cerebral venography: comparison of CT and MR projection venography. AJR Am J Roentgenol. 1997;169(6):1699- 707.
- Vogl T, Bergman C, Villringer A, Einhaupal K, Lissner J, Felix R. Dural sinus thrombosis: value of venous MRA for diagnosis and follow up. Am J Radiology 1994; 162:1191-8.
- Chen WL, Chang SH, Chen JH, Wu YL. Isolated headache as the sole manifestation of dural sinus thrombosis: a case report with literature review. Am J Emerg Med. 2007;25(2):218-9.
- Leach JL, Strub WM, Gaskill-Shipley MF. Cerebral venous thrombus signal intensity and susceptibility eff ects on gradient recalled-echo MR imaging. AJNR Am J Neuroradiol. 2007;28(5):940-5.
- Schellinger PD, Chalela JA, Kang DW, et al. Diagnostic and prognostic value of early MR imaging vessel sign in hyperacute stroke patients imaged
- Wintermark M, Albers GW, Alexandrov AV, Alger JR, Bammer R, Baron JC, et al. Acute stroke imaging research roadmap. AJNR Am J Neuroradiol. 2008;29(5):e23-30.
- Reichenbach JR, Venkatesan R, Schillinger DJ, et al. Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology 1997;204(1):272-77.
- Ogawa S, Lee TM, Kay AR, et al. Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci USA 1990;87:9868-72.
- Edelman RR, Johnson K, Buxton R, Shoukimas G, Rosen BR, Davis KR, Brady TJ. MR of hemorrhage: a new approach. AJNR Am J Neuroradiol. 1986;7(5):751-6.
- Kidwell CS, Chalela JA, Saver JL, et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA 2004;292:1823-1830.
- Fiebach JB, Schellinger PD, Gass A, Kucinski T, Siebler M, Villringer A, et al. Stroke magnetic resonance imaging is accurate in hyperacute intracerebral hemorrhage: a multicenter study on the validity of stroke imaging. Stroke. 2004;35(2):502-6.
- Kaya D, Dinçer A, Yildiz ME, Cizmeli MO, Erzen C. Acute ischemic infarction defi ned by a region of multiple hypointense vessels on gradient-echo T2* MR imaging at 3T. AJNR Am J Neuroradiol. 2009;30(6):1227-32.
- Ameri A, Bousser MG. Cerebral venous sinus thrombosis. Neurol Clin. 1992;10:87-11.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2011 |
| Yayımlandığı Sayı | Yıl 2011Sayı: 1 |