Giant arachnoid granulation misdiagnosed as transverse sinus thrombosis
Giant arachnoid granulation misdiagnosed as transverse sinus thrombosis
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DOI：
10.3340/jkns.2008.43.1.48
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发表时间：
2008-01-01
影响因子：
1.6
通讯作者：
Cha, Jae Hun
中科院分区：
文献类型：
--
作者：
Choi, Hyuk Jin;Cho, Chang Won;Cha, Jae Hun
我们经历了一个巨大的蛛网膜肉芽肿误诊为硬脑膜窦血栓形成的病例。一位66岁的女性提出了一个月的历史进行性枕部头痛。计算机断层扫描血管造影和脑血管造影显示横窦处圆形充盈缺损，推测为横窦血栓形成。进行抗凝治疗以防止血栓形成恶化2周，然后进行钆增强磁共振成像扫描。横窦充盈缺损病灶显示一个无强化颗粒，中央线性强化，与巨大蛛网膜颗粒相一致。为了排除头痛的原因，我们检查了病变处和硬脑膜窦的窦内压差。静脉压正常，病变两侧无明显压差。头痛用药物治疗。
We experienced a case of giant arachnoid granulation misdiagnosed as dural sinus thrombosis. A 66-year-old woman presented with a one month history of progressive occipital headache. Computed tomography angiography and cerebral angiography showed a round filling defect at the transverse sinus which was speculated as a transverse sinus thrombosis. Anticoagulation therapy was performed to prevent worsening of thrombosis for 2 weeks and then a Gadolinium-enhanced magnetic resonance imaging scan was performed. The filling defect lesion at the transverse sinus revealed a non-enhancing granule with central linear enhancement, which was compatible with giant arachnoid granulation. We checked the intrasinus pressure difference across the lesion the through the dural sinus in order to exclude the lesion as the cause of headache. Normal venous pressure with no significant differential pressure across the lesion was noted. Headache was treated with medical therapy.