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A Case of Cerebral Venous Thrombosis Causing Refractory Intracerebral Hemorrhage Naoki KATO 1 , Ryousuke MORI 1 , Koujirou SEKI 1 , Yasuto NODA 1 , Satoru MOROOKA 1 , Masayo MORITA 2 , Toshihide TANAKA 3 , Toshiaki ABE 4 1Department of Neurosurgery,Fuji City General Hospital 2Department of Neurology,Fuji City General Hospital 3Department of Neurosurgery,Jikei University School of Medicine,Kashiwa Hospital 4Department of Neurosurgery,Jikei University School of Medicine Keyword: cerebral venous thrombosis , surgical treatment , intracerebral hemorrhage , pulmonary embolism , thrombolytic therapy pp.51-55
Published Date 2009/1/10
DOI https://doi.org/10.11477/mf.1436100872
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 Cerebral venous thrombosis is an uncommon disease characterized by expansive cerebral edema, venous infarction and massive intracerebral hemorrhage. Magnetic resonance imaging and angiography are useful for diagnosis of cerebral venous thrombosis.

 A 54-year-old man was admitted with headache, vomiting and right hemiparesis. Computed tomography (CT) revealed subcortical hematoma in the left parietal lobe. Digital subtraction angiography (DSA) demonstrated occlusion of the left Labbé vein with dilation of cortical veins and deep cerebral veins. He also suffered from pulmonary embolization and deep vein thrombosis in the lower extremities. Anticoagulant and thrombolytic agents were administered, then respiratory condition and hemiparesis were improved. However, his condition deteriolated 7 months after the initial attack. CT revealed huge subcortical hematoma in the same site. He underwent craniotomy and intracerebral hematoma was evacuated during treatment with vitamin K. His symptom gradually improved and he was discharged with moderate disability 2 months after operation.

 Dicision of surgical treatment is difficult because there is a risk of rebleeding due to thrombolytic therapy and progressive venous congestion. Since anticoagulant and thrombolytic therapy are inevitable, surgical indication for refractory intracerebral hemorrhage associated with cerebral venous thrombosis should be considered carefully.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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