Dural Sinus Thrombosis with Nonsymptomatic Persistent Falcine Sinus: A Case Report
Dural Sinus Thrombosis with Nonsymptomatic Persistent Falcine Sinus: A Case Report
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硬脑膜窦血栓形成伴无症状持续性镰状窦：一例报告
DOI：
10.1016/j.jstrokecerebrovasdis.2019.104309
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发表时间：
2019
影响因子：
2.5
通讯作者：
Tamaoka Akira
中科院分区：
文献类型：
--
作者：
Shioya Ayako;Mashiko Ryota;Shiigai Masanari;Nakai Yasunobu;Takahashi Nobuyuki;Kobayashi Hiroyuki;Irie Toshiyuki;Tamaoka Akira
一位24岁的女性因惊厥性癫痫持续状态入院。脑磁共振静脉造影显示持续胎儿镰状窦。此外，上级矢状窦后三分之一发育不良，并伴有异常深静脉引流。这些异常在几年前已经被磁共振成像检测到。在目前的扫描中，我们发现在发育不全的上级矢状窦内有一个窦血栓形成。在脑血管造影中，我们观察到左侧顶枕叶静脉回流延迟，并假设血栓导致的脑静脉淤滞导致惊厥性癫痫持续状态。患者接受肝素沿着抗癫痫药物静脉给药治疗，患者恢复，无神经功能缺损。在本病例中，镰状窦和静脉回流异常可能是先天性的，而癫痫持续状态则是由发育不良的上上级矢状窦血栓形成引起的。虽然镰状窦是上级矢状窦的替代通道，发育不良的上级矢状窦本身也可能作为静脉引流通道发挥重要作用。
A 24-year-old woman was admitted to our hospital after convulsive status epilepticus. A cerebral magnetic resonance venography revealed a persistent fetal falcine sinus. Additionally, the posterior third of the superior sagittal sinus was hypoplastic and the abnormal deep venous drainage was accompanied. These abnormalities had already been detected by magnetic resonance imaging several years ago. In the present scan, we discovered a sinus thrombosis in the hypoplastic superior sagittal sinus. In the cerebral angiography, we observed delayed venous return in the left parieto-occipital lobe and hypothesized that cerebral venous stasis due to the thrombus caused the convulsive status epilepticus. The patient was treated with intravenous administration of heparin along with an antiepileptic drug, and she recovered with no neurological defects. In the present case, the falcine sinus and the anomalous venous return were likely congenital while the status epilepticus was derived from thrombosis in the hypoplastic superior sagittal sinus. Although the falcine sinus functioned as an alternative pathway for the superior sagittal sinus, the hypoplastic superior sagittal sinus itself may also play an important role as a venous drainage channel.