潜在性Basedow病に合併した脳静脈洞血栓症の1症例

A Case of Cerebral Venous Sinus Thrombosis, Secondary to Subclinical Basedow Disease

Ⅰ．はじめに

　脳静脈洞血栓症は比較的稀な脳卒中であり，危険因子として感染，経口避妊薬，妊娠，心疾患，悪性腫瘍，血液凝固異常，術後，外傷などが一般的に知られている^7,9)．また近年では，甲状腺機能亢進に伴い凝固・線溶系の異常を来すことで脳静脈洞血栓症を発症することが報告されている^1-6,8,10,11)．

　今回われわれは，潜在性バセドウ病に伴う脳静脈洞血栓症を呈した比較的稀な1症例を経験したので，文献的考察を加え報告する．

　Cerebral venous sinus thrombosis（CVST）is a rare condition accounting for ＜1% of all strokes. It has been linked to a multitude of risk factors, including infections, oral contraceptive use, coronary disease, malignant disease, trauma, surgery, coagulopathy and several others. However, the association between hyperthyroidism and CVST is poorly understood.

　We describe here a rare case of CVST, secondary to subclinical Basedow disease. A 68-year-old woman with general fatigue, headache, speech disturbance and slow behavior was admitted to our hospital. Computed tomography（CT）and magnetic resonance imaging revealed a fresh infarction in the left temporal lobe, and CT angiography revealed filling defects of superior sagittal sinus and transverse sinus. Moreover, the patient was diagnosed with Basedow disease for the first time, by examination for tachycardia.

　This case suggests that it is essential to have a new awareness that hyperthyroidism is an important risk factor for CVST.