上矢状静脈洞血栓症を合併した潰瘍性大腸炎の1例

Superior Sagittal Sinus Thrombosis Suffered as a Complication of Ulcerative Colitis：Case Report

Ⅰ．は じ め に

　1930年代にBargen とBarker ³⁾ によって，潰瘍性大腸炎の患者においては静脈血栓症を生じやすいことが初めて報告されて以来，潰瘍性大腸炎に深部静脈血栓症や肺塞栓症が合併しやすいことは広く認知されている．われわれは，活動性の潰瘍性大腸炎患者で，上矢状静脈洞の完全閉塞を認めた症例を経験したので文献的考察を加えて報告する．

　A case of superior sagittal sinus thrombosis which was complicated with ulcerative colitis is reported. A 16-year-old male patient had a 2-year history of ulcerative colitis. He was admitted to our hospital complaining of abdominal pain,bloody bowel discharge and appetite loss,and was then treated conservatively. Two days after admission,he demonstrated generalized convulsions which were followed by right hemiplegia. MRI showed a low intensity lesion on T1 and an irregular high intensity in the subcortical area of the left frontal lobe on T2 and T2 FLAIR-weighted images. The MRI findings resembled either invasive brain tumor or local inflammation. Cerebral angiography appeared to demonstrate complete obstruction of the superior sagittal sinus with congestion of venous flow in the cortical veins. Ulcerative colitis has been reported to show hypercoagulation,leading to deep vein thrombosis within the body which sometimes causes pulmonary infarction; however,occurrence of venous thrombosis in the intracranial veins and sinus is rare. This report underscores the fact that cerebral venous thrombosis should be suspected in the case of patients with ulceritive colitis who suffer sudden onset of neurological deficits.