Neurological Surgery 脳神経外科46巻1号

2018年01月発行

症例

速やかな改善がみられた著明な脱水に伴う脳静脈洞血栓症の1症例

著者： 川原一郎¹ 豊田啓介¹ 広瀬誠¹ 北川直毅¹

所属機関： ¹長崎労災病院脳神経外科

ページ範囲：P.47 - P.52

Ⅰ．はじめに
　脳静脈洞血栓症（cerebral venous sinus thrombosis：CVST）は，比較的若年での発症が多い稀な疾患である⁶⁾．患者背景として，感染，血液凝固異常，外傷，脱水などが一般的に知られており，症状は多様で特異性はないとされるが，時にtransient ischemic attack様の症状（TIA-like event）で発症する場合もあり，注意が必要である^2,3,7-12)．
　今回われわれは，重度の脱水にて発症し，比較的短時間で速やかな症状の改善がみられたCVSTの症例を経験したので，文献的考察を加え報告する．

参考文献

1) Ayanzen RH, Bird CR, Keller PJ, McCully FJ, Theobald MR, Heiserman JE：Cerebral MR venography：normal anatomy and potential diagnostic pitfalls. AJNR Am J Neuroradiol 21：74-78, 2000

2) Chang DI, Yoon SS, Chung KC：Superior sagittal sinus thrombosis and transient ischemic attacks：possible mechanism. J Korean Med Sci 13：566-568, 1998

3) Coban G, Karalezli A, Horasanlı B, Yeşilırmak N：Transient homonymous hemianopia caused by cerebral venous sinus thrombosis：case report. Can J Ophthalmol 49：e119-123, 2014

4) Devasagayam S, Wyatt B, Leyden J, Kleinig T：Cerebral venous sinus thrombosis incidence is higher than previously thought：a retrospective population-based study. Stroke 47：2180-2182, 2016

5) Einhäupl KM, Masuhr F：Cerebral venous and sinus thrombosis-an update. Eur J Neurol 1：109-126, 1994

6) Saposnik G, Barinagarrementeria F, Brown RD Jr, Bushnell CD, Cucchiara B, Cushman M, deVeber G, Ferro JM, Tsai FY；American Heart Association Stroke Council and the Council on Epidemiology and Prevention：Diagnosis and management of cerebral venous thrombosis：a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42：1158-1192, 2011

7) Scuotto A, D'Avanzo R, Natale M, Rotondo M：Transient ischaemic attack：an exceptional presenting syndrome of a superior sagittal sinus thrombosis. BMJ Case Rep. Nov 21, 2013. bcr2013200894

8) Togay Işıkay C, Kural AM, Erden İ：Cerebral vein thrombosis as an exceptional cause of transient ischemic attack. J Stroke Cerebrovasc Dis 21：907, e9-12, 2012

9) Topsakal C, Cihangiroglu M, Kaplan M, Akdemir I, Tiftikci M：Complete superior and inferior sagittal sinus thromboses with multiple cranial nerve pareses and transient ischemic attack--case report. Neurol Med Chir（Tokyo）42：383-386, 2002

10) Yildiz OK, Cevik S, Cil G, Oztoprak I, Bolayir E, Topaktas S：Cerebral venous sinus thrombosis presenting as transient ischemic attacks in a case with homozygous mutations of MTHFR A1298C and CG677T. J Stroke Cerebrovasc Dis 21：75-77, 2012

11) Yun JH, Ko JH, Lee MJ：Early spontaneous recanalization of sigmoid sinus thrombosis following a closed head injury in a pediatric patient：a case report and review of literature. J Korean Neurosurg Soc 58：150-154, 2015

12) Verma R, Patil TB, Kumar N：Early recanalisation of cerebral venous sinus thrombosis in an unusual case associated with severe protein S deficiency. BMJ Case Rep. Jul 27, 2012. bcr 2012006496