Cerebral venous thrombosis as a complication of nephrotic syndrome —A case report and literature review—

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  • Iwaki Hirotaka
    Department of Neurology, Brain Attack Center Ota Memorial Hospital Present address; Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine
  • Neshige Shuichiro
    Department of Neurology, Brain Attack Center Ota Memorial Hospital
  • Hara Naoyuki
    Department of Neurology, Brain Attack Center Ota Memorial Hospital Present address; Department of Neurology, Hiroshima City Hospital
  • Takeshima Shinichi
    Department of Neurology, Brain Attack Center Ota Memorial Hospital
  • Takamatsu Kazuhiro
    Department of Neurology, Brain Attack Center Ota Memorial Hospital
  • Kuriyama Masaru
    Department of Neurology, Brain Attack Center Ota Memorial Hospital

Bibliographic Information

Other Title
  • ネフローゼ症候群に合併した脳静脈血栓症―2症例の報告と文献レビュー―
  • 症例報告 ネフローゼ症候群に合併した脳静脈血栓症 : 2症例の報告と文献レビュー
  • ショウレイ ホウコク ネフローゼ ショウコウグン ニ ガッペイ シタ ノウ ジョウミャク ケッセンショウ : 2 ショウレイ ノ ホウコク ト ブンケン レビュー

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Abstract

We report two cases of cerebral venous thrombosis as a complication of nephrotic syndrome. No urine protein or kidney disease was noted in either case. The patients were diagnosed with nephrotic syndrome after admission to our hospital. Case 1: The patient was a 46-year-old man. He experienced headache and vomiting the day after he drank heavily. Contrast brain computed tomography (CT) and magnetic resonance imaging (MRI) revealed a defect in the transverse sinus, straight sinus, and superior sagittal sinus. His blood was hemo-concentrated, and blood test results indicated high D-dimer and fibrinogen levels and decrease of antithrombin III. Case 2: The patient was an 89-year-old woman. After the diarrhea lasted suffering from ischemic colitis, she developed left hemiplegia and headache. Brain CT revealed hematoma in the subcortical region of the right frontal lobe and a high signal in the straight sinus. The superior sagittal sinus showed high-signal intensity on T1-weighted MRI and mild high-signal intensity on T2-weighted MRI. High fibrinogen levels were detected in the blood. Patients with nephrotic syndrome have a thrombotic tendency; both venous thrombosis and arterial thrombosis may occur. In the literature, the number of published cases of cerebral venous thrombosis was 10-fold that of cerebral artery thrombosis as a complication of nephrotic syndrome in individuals aged <20 years. In adults, however, the number of cerebral venous thrombosis was 2-fold that of cerebral artery thrombosis cases were reported. Nephrotic syndrome shows a thrombotic tendency, but cerebral venous thrombosis may develop as a result of another thrombotic factor. Management of life along with the conventional treatment of nephrotic syndrome is important.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 54 (6), 495-501, 2014

    Societas Neurologica Japonica

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