脳静脈洞血栓症を合併した縊首の1例

A Case of Neck Hanging Complicated by Cerebral Sinus Thrombosis

Ⅰ．はじめに

　静脈洞血栓症の原因は，脱水・外傷・感染・妊娠・経口避妊薬等，多岐にわたる²⁾．しかし，縊首により発症したという報告は，渉猟し得た範囲では認められなかった．今回われわれは，縊首後に意識障害を呈し，来院時の頭部CT上右側優位脳腫脹を認め，当初低酸素脳症による脳腫脹と考えたが，後の画像と臨床像から脳腫脹は静脈洞血栓症によるものと判明した症例を経験した．そこで，文献的にその機序を考察したのでここに報告する．

A 43-year-old male with respiratory arrest due to neck hanging was resuscitated at the scene. The head CT on arrival showed diffuse brain swelling predominantly in the right cerebral hemisphere. The swelling improved but right transverse sinus thrombosis was recognized on the 4th hospital day. His conscious state gradually recovered and recanalization of the sinus was confirmed on a subsequent MR venography. He was discharged without neurological deficit. A sinus thrombosis should be considered as a differential diagnosis of brain swelling after hanging.