Cerebral venous sinus thrombosis following transsphenoidal surgery for craniopharyngioma: A case report

BACKGROUND Cerebral venous sinus thrombosis(CVST)is a rare condition in patients with craniopharyngioma following transsphenoidal surgery.CASE SUMMARY A 56-year-old man who underwent transsphenoidal surgery for craniopharyngioma 26 d ago presented gradual headache and cerebrospinal fluid leakage while vomiting 5 d post-discharge and required readmission to our department of neurosurgery.After admission,head imaging examination showed a hyperdense shadow in the superior sagittal sinus and right transverse sinus,edema at the bilateral parietal lobe,and hemorrhage at the left parietal lobe and right occipital lobe;the venous phase of cerebral angiography revealed CVST.The patient was treated immediately by intravenous thrombolysis,endovascular thrombolysis,and mechanical thrombectomy after the definite diagnosis.However,the neurological status of the patient continued to deteriorate and he died on the fourth day after readmission.CONCLUSION For craniopharyngioma undergoing transsphenoidal surgery,it is vital to take an effective strategy to manage the postoperative complications,such as diabetes insipidus,severe electrolyte imbalance,and cerebrospinal fluid leakage.Additionally,the early differential diagnosis of CVST is essential when it develops clinical symptoms,especially in patients following transsphenoidal surgery with a high risk of CVST.Subsequently,the timely and effective treatment of the CVST is critical for preventing neurological deterioration.     

Successful treatment of cerebral venous sinus thrombosis by balloon venoplasty: a case report

Cerebral venous sinus thrombosis is a special cerebrovascular disease affecting young adult and middle-aged people. The clinical manifestations of cerebral venous sinus thrombosis are diverse and nonspecific; thus, imaging plays an important role in early diagnosis. Anticoagulation with heparin is the preferred treatment for cerebral venous sinus thrombosis. Endovascular treatment is also being increasingly used to achieve recanalization of the cerebral venous sinus. We herein describe a woman in her early 50s who was diagnosed with cerebral venous sinus thrombosis for which anticoagulation with heparin was ineffective. To improve her symptoms and prognosis, we selected balloon venoplasty to treat the right sigmoid sinus thrombosis. Her condition subsequently improved, and no recurrence was observed after several follow-ups.     

机械性碎栓联合接触性溶栓治疗颅内静脉窦血栓的护理

颅内静脉窦血栓形成发病率低,容易误诊或漏诊,增加该病的致残率和致死率,文献报道死亡率达6％～15％[1].早期诊断,迅速疏通闭塞的静脉窦有助于减少该病的并发症,降低致残率和致死率.2005年2月～2010年6月我科运用机械性碎栓联合接触性溶栓治疗颅内静脉窦血栓形成(CVST) 12例,取得较好的临床疗效,现将护理体会报告如下.     

空气波压力治疗仪对下肢深静脉血栓取栓术后肢体肿胀和血栓复发的干预效应

为观察空气波压力治疗仪辅助治疗对下肢深静脉血栓取栓术后患肢肿胀和血栓复发的影响,选择2004-09/2005-07泸州医学院附属医院收治下肢深静脉血栓取栓术后患者62例,按随机原则分为实验组和对照组,对照组采用肢体术后常规护理,实验组在对照组基础上加空气波压力治疗仪辅助治疗(30min/次,1次/d,14d为1个疗程,连续2个疗程),观察两组患者治疗前后肢体周径,血栓复发率和患肢冷感评分。结果显示经28d治疗后,实验组患者大小腿周径缩小,冷感评分降低,与治疗前和对照组比较差异有显著性意义(P<0.01);且实验组血栓复发明显低于对照组(P<0.05)。提示空气波压力治疗仪能有效的减轻深静脉血栓取栓术后肢体肿胀和预防血栓复发。     

Left ventricular apical and atrial appendage thrombus with hypertrophic cardiomyopathy in sinus rhythm: a case report

A 47-year-old female with a history of untreated hypertension and diabetes mellitus was referred because of a left ventricular echocardiographic mass with congestive heart failure. At the time of admission, she had already had a cardio-embolic stroke with loss of recent memory and slight paralysis of the right upper arm. It was difficult to distinguish between thrombus and tumor. However, her clinical condition required surgical resection as soon as possible. We performed cardiac CT to evaluate the coronary arteries and to scan the mass at the left ventricular apex. This CT evaluation revealed another mass at the left atrial appendage. Thus, these two masses were highly suggestive of thrombi. Subemergency surgical resection of the two masses and a part of the myocardium at the left ventricular apex was successfully performed. The pathological results showed that both the mass in the left ventricular apex and the mass in the left atrial appendage were thrombi, and the myocardial disarray confirmed the echocardiographic diagnosis as hypertrophic cardiomyopathy.     

超声诊断冠状静脉窦与左心房间接相通一例

患者,男性,53岁,因"外院查体二尖瓣关闭不全"为求手术治疗入院,入院一般情况较好,无特殊病史.心电图提示:窦性心率,心电图异常;左心房肥大. 入院超声心动图提示:二尖瓣前瓣脱垂并关闭不全;二叶式主动脉瓣伴轻度狭窄及钙化;左心室收缩功能正常.     

Portal venous tumor thrombus associated with hepatic metastasis of renal cell carcinoma: case report

We report a case of liver metastasis of renal cell carcinoma with portal venous tumor thrombus. Abdominal computed tomographic images showed a large hepatic mass that enhanced slightly during arterial phase. Multiple hypoattenuating lesions were seen in the intrahepatic portal venous branches and were traced directly from the mass. The histologic specimen confirmed metastatic liver tumor of renal cell carcinoma with portal venous tumor thrombus.     

Cerebral venous thrombosis: a case report

The incidence of cerebral venous thrombosis (CVT) is three to four cases per one million in adults and seven cases per one million among children. We discuss a case of CVT in a 19-year-old woman with a history of migraine headaches. A CVT most commonly presents acutely, with a wide variety of signs and symptoms in young adults and children. The most common presenting complaint in adults is severe headache. The most frequently thrombosed sinuses are the lateral, cavernous, and superior sagittal sinuses. Risk factors include any genetic or acquired prothrombotic conditions, including pregnancy and the peripartum period. Computed tomography may show the classic "delta sign," although magnetic resonance imaging with magnetic resonance venography is more sensitive. Treatment is controversial at this time. Options include fibrinolysis, anticoagulation, mechanical thrombectomy, or surgery. Despite the lack of agreement on management of CVT, the prognosis of CVT has improved, due to an increasing frequency of diagnosis.     

Rotarex mechanical thrombectomy in renal artery thrombosis: A case report

BACKGROUNDAcute renal artery thrombosis is a relatively rare disease. Early diagnosis and emergent treatment can prevent the loss of renal function and the development of hypertension.CASE SUMMARYWe report a patient with acute renal artery thrombosis who presented to our hospital with acute-onset right flank pain and was treated by percutaneous mechanical thrombectomy using the Rotarex device. After 2 mo, right kidney function had recovered slightly.CONCLUSIONRenal artery thrombosis may lead to loss of renal function and the development of hypertension. Rotarex mechanical thrombectomy may be a viable treatment option for rapid recanalization of the renal artery in patients with renal artery thrombosis.     

Magnetic resonance black-blood thrombus imaging can confirm chronic cerebral venous thrombosis: a case report and literature review

BackgroundCerebral venous thrombosis (CVT) is easily missed or misdiagnosed in clinical settings because of its high variability in terms of symptoms and radiological findings. Herein, we aimed to explore a promising modality for confirming presumed CVT in the hope to uncover its superior diagnostic performance to conventional imaging modalities.Case presentation: The patient complained of intolerable pain in her forehead and left eye. Her lumbar puncture opening pressure was 140 mmH₂O, and her cerebrospinal fluid composition was normal. No marked abnormalities were observed in routine brain images, including non-contrast computed tomography, magnetic resonance imaging, and contrast-enhanced magnetic resonance venography. However, chronic mural thrombi in the lumen of the left cortical veins, transverse/sigmoid sinus, and superior sagittal sinus were identified in magnetic resonance black-blood thrombus imaging (MRBTI) maps.ConclusionsMRBTI can be used to directly and non-invasively visualize thrombi, and may thus be a promising tool over alternative routine techniques for confirming the diagnosis of CVT.     

颅内原发性Rosai-Dorfman病一例

患者男,57岁,于4个多月前情绪激动时出现头晕、步态不稳等不适,以右侧枕部为著,无规律或多出现于用力时,伴左眼视力下降,无恶心、呕吐,无吞咽困难、饮水呛咳.发病后在外院就诊头颅CT提示:右侧颞叶占位性病变.遂于川北医学院附属医院进一步就诊.入院体格检查示:双眼视力下降,左眼颞侧视野有缺损,左侧瞳孔直接对光反射迟钝;浅表...     

肾病综合征并发颅内静脉窦血栓的护理效果观察

目的探讨应用尿激酶与低分子肝素等联合治疗肾病综合征患儿并发颅内静脉窦血栓后的护理效果。方法采用尿激酶与低分子肝素等联合治疗,观察血压、神志、尿量、肢体色泽、温度及有无皮下出血情况。结果观察发现肾病综合者患儿在激素治疗的过程中易合并高凝状态,肾病综合征的高凝状态是静脉血栓形成的基础,临床上一旦患儿血压升高并发头痛、头昏、嗜睡、呕吐等症状时,应尽早进行头颅CT或MRI检查以便了解有无头颅静脉血栓,并常规运用尿激酶与低分子肝素联合治疗。结论早期应用尿激酶抗纤溶、低分子肝素抗凝及抗血小板凝聚药物综合治疗,其溶栓疗效较好。本文对儿童肾病综合征并发颅内静脉窦血栓的早期护理观察具有推广价值。     

围生期颅内静脉窦血栓形成误诊原因分析

围生期颅内静脉窦血栓形成 (CVST)为较少见的血栓栓塞性疾病 ,临床表现多样而无特异性 ,常易误诊。我院 1990年 5月～ 2 0 0 0年 10月收治CVST 6例 ,均误诊。现将误诊原因分析如下。1　临床资料1 1　一般资料　本组 6例年龄 2 2～ 38岁 ,平均 2 8 3岁 ;发病时间 :妊娠 32 + 5周、妊娠 36 + 4 周、产后 2天、5天、6天、9天各 1例。原发病 :妊娠高血压综合征 3例 ,合并原发性高血压 1例。既往分娩情况 :最少 0次 ,最多 4次 ,平均 2 2次。1 2　临床表现　症状 :头痛 6例 ,呕吐、视盘水肿各 5例 ,发作性四肢抽搐 4例 ,发热 3例 ,意识障碍、…     

颅内静脉窦和脑静脉血栓形成的临床和影像学诊断探讨

目的探讨诊断颅内静脉窦和脑静脉血栓形成的方法。方法对 6例颅内静脉窦和脑静脉血栓形成的临床及影像学资料进行分析。结果患者多表现颅内高压征象 ,伴有全脑症状或局灶神经功能异常。头颅MRI及磁共振静脉成像 (MRV)诊断颅内静脉窦和脑静脉血栓形成有肯定的价值 ,而血管数字减影 (DSA)是诊断该病的最可靠手段。结论根据临床表现及影像学检查可确诊颅内静脉窦和脑静脉血栓形成。     

Aneurysmal portosystemic venous shunt: a case report

A case of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound (CDUS) is presented. A young female patient complained of postprandial fatigue and had paroxysmal tachycardia. A direct vascular communication between right portal vein and right hepatic vein was found at CDUS and confirmed by direct portal angiogram. Using detachable coils a complete occlusion of the intrahepatic shunt was obtained. Reports from the literature regarding portovenous aneurysms are reviewed.     

2例严重颅内静脉窦血栓经静脉接触性溶栓联合机械性破栓病人的护理

颅内静脉及静脉窦血栓形成(cranialvenousandsinusthrombosis,CVST)是由多种病因所致的,是以脑静脉回流受阻、脑脊液吸收障碍为特征的一种脑血管病特殊类型[1],按病变性质可分为炎症性和非炎症性,一般多为炎症性,临床表现多种多样,误诊率高达50%[2].抗凝治疗是该病首选疗法,但是部分病人由于广泛血栓形成、局限性狭窄等原因致病情进行性恶化,抗凝治疗疗效差、病程长、并发症多[3].     

Hypereosinophilia with cerebral venous sinus thrombosis and intracerebral hemorrhage: A case report and review of the literature

BACKGROUNDHypereosinophilia (HE) is defined as a peripheral blood eosinophil count of > 1.5 × 10⁹/L and may be associated with tissue damage. The clinical presentations of HE vary; however, myocardial fibrosis and thrombosis can threaten the lives of patients with sustained eosinophilia. Cerebral venous sinus thrombosis (CVST) in the setting of eosinophil-related diseases has seldom been reported. Here, we review the literature on HE with CVST to increase knowledge and encourage early diagnosis.CASE SUMMARYA previously healthy 41-year-old man was admitted to hospital with diarrhea and abdominal pain. He was treated with antibiotics for suspected acute colitis. Three days later, he experienced headache and vomiting. Brain computed tomography (CT) revealed thrombosis of the left jugular vein to the left transverse sinus vein. Platelet (PLT) count decreased to 60 × 10¹²/L, and absolute eosinophil count (AEC) increased to 2.41 × 10⁹/L. He was treated with low-molecular-weight heparin. PLT count progressively decreased to 14 × 10⁹/L, and we terminated anticoagulation and performed PLT transfusion. Six days after admission, he complained of a worsening headache. Brain CT revealed right temporal lobe and left centrum semiovale intracerebral hemorrhage, and AEC increased to 7.65 × 10⁹/L. We used prednisolone for HE. The level of consciousness decreased, so emergency hematoma removal and decompressive craniectomy for right cerebral hemorrhage were performed. The patient was alert 2 d after surgery. He was treated with anticoagulation again 2 wk after surgery. Corticosteroids were gradually tapered without any symptomatic recurrence or abnormal laboratory findings. CONCLUSIONHE can induce CVST, and we need to focus on eosinophil counts in patients with CVST.