脳内出血にて発症したネフローゼ症候群に伴う上矢状静脈洞血栓症の1例

A case of intracranial hemorrhage following superior sagittal sinus thrombosis associated with nephrotic syndrome

I．はじめに

　年長児の脳内出血の原因として外傷性をのぞくと脳動静脈奇形，脳動脈瘤，血液疾患，腫瘍，もやもや病などの非外傷性脳内出血が知られているが，静脈洞血栓症に伴う脳内出血は稀である．今回われわれは脳内出血にて発症したネフローゼ症候群に伴う上矢状静脈洞血栓症の1例を経験し，その発生原因につき検討したので報告する．

A case of intracranial hemorrhage due to superior sagittal sinus thrombosis occurring in a boy with nephrotic syndrome is described. A twelve-year-old boy with nephrotic syndrome presented sudden onset of generalized convulsions. CT scan revealed a subcortical hematoma in the left frontal lobe. A left carotid angio-graphy revealed the occlusion of the superior sagittal sinus.

Neurological findings included disturbance of con-sciousness, right hemiparesis, and motor aphasia after the convulsions. All symptoms and signs disappeared immediately. There has been no evidence of rebleeding or convulsions for the last two years.

This case had no abnormality of the coagulation sys-tem in routine investigation, but nephrotic syndrome and steroid therapy appeared to be associated with se-veral disorders of the coagulation system.

The authors suggested that it was necessary to pay attention to possible intracranial hemorrhage caused by cerebral venous sinus thrombosis in patients with nephrotic syndrome or who had undergone steroid the-rapy.