速やかな改善がみられた著明な脱水に伴う脳静脈洞血栓症の1症例

Rapid Recanalization of Cerebral Venous Sinus Thrombosis Secondary to Severe Dehydration:A Case Report

Ⅰ．はじめに

　脳静脈洞血栓症（cerebral venous sinus thrombosis：CVST）は，比較的若年での発症が多い稀な疾患である⁶⁾．患者背景として，感染，血液凝固異常，外傷，脱水などが一般的に知られており，症状は多様で特異性はないとされるが，時にtransient ischemic attack様の症状（TIA-like event）で発症する場合もあり，注意が必要である^2,3,7-12)．

　今回われわれは，重度の脱水にて発症し，比較的短時間で速やかな症状の改善がみられたCVSTの症例を経験したので，文献的考察を加え報告する．

　A 41-year-old healthy man presented with sudden disturbance of consciousness and convulsion during a marathon. Computed tomography revealed a lateral sinus sign in the posterior fossa, and magnetic resonance（MR）venography revealed a flow gap in the posterior part of the superior sagittal sinus and bilateral transverse sinus, although the other MR image sequences were normal. Laboratory data revealed dehydration, acute kidney failure, and rhabdomyolysis. Owing to immediate correction of dehydration, clinical symptoms and radiological abnormality improved rapidly.

　Cerebral venous sinus thrombosis（CVST）is a rare condition, accounting for ＜1% of all stroke cases. In all cases, CVST cannot cause cerebral infarction or hemorrhagic change but in any case, may present a transient ischemic attack-like event because of rapid spontaneous recanalization. Therefore, CVST may occur more frequently than expected.