Cerebral venous sinus thrombosis in the patient with multiple sclerosis associated with congenital antithrombin deficiency

  • Kanaya Yuhei
    Department of Neurology, and Department of Radiology, Brain Attack Center Ota Memorial Hospital
  • Takamatsu Kazuhiro
    Department of Neurology, and Department of Radiology, Brain Attack Center Ota Memorial Hospital
  • Shimoe Yutaka
    Department of Neurology, and Department of Radiology, Brain Attack Center Ota Memorial Hospital
  • Niimi Hideki
    Toyama University Hospital Clinical Laboratory
  • Kitajima Isao
    Toyama University Hospital Clinical Laboratory
  • Kuriyama Masaru
    Department of Neurology, and Department of Radiology, Brain Attack Center Ota Memorial Hospital

Bibliographic Information

Other Title
  • 先天性アンチトロンビン欠損症による脳静脈洞血栓症を併発した多発性硬化症の1例

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Abstract

We report the case of a 25-year-old man with multiple sclerosis (MS) who had severe headache and unconsciousness. He suffered from optic neuritis that had started at age 6. From the age of 12 years, he had suffered from multiple sclerosis (MS) cerebral lesions that relapsed three times over for 5 years. At age 25, he showed a new lesion in the cerebellar cortex, suggesting an exacerbation of the MS. However, magnetic resonance imaging findings the next day showed cerebral venous sinus thrombosis. His laboratory findings showed low antithrombin activity. Genetic analysis revealed a single-base substitution (C>T) at the codon 359 (Arg to STOP) in the 5th exon portion of the antithrombin gene, heterozygote. In the literature review, 17 cases of multiple sclerosis associated with cerebral venous sinus thrombosis, which occurred after the lumbar puncture and the treatment with high-dose methylpredonisolone in 11 of these cases. In our case, antithrombin deficiency, hyperhomocystinemia, infection, and lumbar puncture were suggested as the risk factors.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 56 (4), 248-254, 2016

    Societas Neurologica Japonica

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