Isolated deep cerebral venous thrombosis
DOI: 10.32364/2587-6821-2020-4-9-595-600
T.V. Matveeva1, M.M. Ibatullin1, R.T. Gaifutdinov1, A.Yu. Kazantsev1, A.R. Altynbaie2,
G.A. Fasakhova2, S.I. Safiullina3
1Kazan State Medical University, Russian Federation
2Central City Clinical Hospital No. 18, Kazan, Russian Federation
3Medical Center «Aibolit» on Kurskaya LLC, Kazan, Russian Federation
Deep cerebral venous thrombosis is a rare pathology and hard to diagnose cause of the acute cerebrovascular diseases. Commonly, the veins of Galen and Rosenthal affected by the non-isolated deep cerebral venous thrombosis are described in most of the publications. The article presents a clinical case of an extremely rare isolated deep cerebral venous thrombosis in a female patient aged 31 years with a burdened obstetric history and thrombophilia. The disease onset started with increasing hypertension headache, congestive changes in the fundus, cerebellar and pyramidal signs. Magnetic resonance imaging (MRI) of the brain revealed a pattern of a multi-focal brain lesion. Thus, the primary diagnosis of «multiple sclerosis» was established, so the patient received pulse therapy. Differential diagnosis was conducted with systemic connective tissue diseases. Regression of headaches, of changes in the fundus, dynamic neuroimaging data, and the results of hematol ogy test made it possible to diagnose «deep cerebral venous thrombosis». During the anticoagulant therapy, there was a positive dynamics: the foci significantly regressed according to MRI data, the patient became pregnant and delivered a healthy child. The article describes the characteristics of MRI images on deep cerebral venous thrombosis, which can be used to diagnose this pathology.
Keywords: deep cerebral venous thrombosis, сerebral venous sinus thrombosis, thrombophilia, coagulopathy, infertility, headache, multiple sclerosis.
For citation: Matveeva T.V., Ibatullin M.M., Gaifutdinov R.T. et al. Isolated deep cerebral venous thrombosis. Russian Medical Inquiry. 2020;4(9):595–600. DOI: 10.32364/2587-6821-2020-4-9-595-600.
About the authors:
Tatiana V. Matveeva — Dr. of Sci. (Med.), Professor of the Department of Neurology, Neurosurgery and Medical Genetics, Kazan State Medical University: 49, Butlerova str., Kazan, 420012, Russian Federation.
Murat M. Ibatullin — Dr. of Sci. (Med.), Professor of the Department of Neurology, Neurosurgery, Faculty of Continuing Education and Professional Development, Kazan State Medical University: 49, Butlerova str., Kazan, 420012, Russian Federation.
Rustem T. Gaifutdinov — Cand. of Sci. (Med.), Associate Professor of the Department of Neurology, Neurosurgery and Medical Genetics, Kazan State Medical University: 49, Butlerova str., Kazan, 420012, Russian Federation; ORCID iD 0000-0001-5591-7148.
Alexandr Yu. Kazantsev — neurologist, Assistant Professor of the Department of Neurology, Neurosurgery and Medical Genetics, Kazan State Medical University: 49, Butlerova str., Kazan, 420012, Russian Federation; ORCID iD 0000-0001-9800-9940.
Artur R. Altynbaev — neurologist, Central City Clinical Hospital No. 18: 2, Kh. Mavlyutova, Kazan, 420101, Russian Federation.
Gulnaz A. Fasakhova — Cand. of Sci. (Med.), neurologist, Central City Clinical Hospital No. 18: 2, Kh. Mavlyutova, Kazan, 420101, Russian Federation.
Svetalana I. Safiullina — Cand. of Sci. (Med.), hematologist, Medical Center «Aibolit» on Kurskaya LLC: 8A, Kurskaya str., Kazan, 420081, Russian Federation.
Contact information: Alexander Yu. Kazantsev, e-mail: engine90@bk.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 25.01.2020, revised 07.02.2020, accepted 21.02.2020.
2. Ferro J.M., Canhao P., Stam J. et al. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–670. DOI: 10.1161/01.STR.0000117571.76197.26.
3. Behrouzi R., Punter M. Diagnosis and management of cerebral venous thrombosis. Clin Med. 2018;18(1):75–79. DOI: 10.7861/clinmedicine.18-1-75.
4. Matveeva T.V. Neurology. Clinical lecture. Kazan: Meditsinskaya kniga; 2014 (in Russ.).
5. Mashin V.V., Belova L.A., Moiseev M.Yu., Proshin A.N. A comparative clinical and neuroimaging study of venous and arterial strokes. Annals of Clinical and Experimental Neurology. 2015;4:24–31 (in Russ.).
6. Makotrova T.A., Sotnikov A.S., Levin O.S. Venous infarct due to transverse sinus thrombosis with clinical manifestation of isolated alexia syndrome. The Neurological Journal. 2013;18(4):29–34 (in Russ.). DOI: 10.18821/1560-9545-2013-18-4-29-34.
7. Semenov S.E., Kovalenko A.V., Khromov A.A. et al. Diagnostic criteria for non-hemorrhagic venous stroke by X-ray multispiral (MSCT) and magnetic resonance imaging (MRI) imaging. Complex issues of cardiovascular diseases. 2012;1:43–53 (in Russ.).
8. Chung S.W., Hwang S.N., Min B.K. et al. Unilateral Thrombosis of a Deep Cerebral Vein Associated with Transient Unilateral Thalamic Edema. J Cerebrovasc Endovasc Neurosurg. 2014;14(3):233–236. DOI: 10.7461/jcen.2012.14.3.141.
9. Pfefferkorn T., Crassard I., Linn J. et al. Clinical features, course and outcome in deep cerebral venous system thrombosis: an analysis of 32 cases. J Neurol. 2009;256:1839–1845. DOI: 10.1007/s00415-009-5206-3.
10. Zheng H., Xu W., Chen Y. et al. A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma Case report. Medicine (Baltimore). 2018;97(36):e11587:36. DOI: 10.1097/MD.0000000000011587.
11. Bousser M.G., Ferro J.M. Cerebral venous thrombosis: An update. Lancet Neurol. 2007;6:162–170. DOI: 10.1016/S1474-4422 (07) 70029-7.
12. Narra R., Kamaraju S.K., Pasupaleti B., Juluri N. Case of Cerebral Venous Thrombosis with Unusual Venous Infarcts. J Clin Diag Res. 2015;9(4):TD08–10. DOI: 10.7860/JCDR/2015/12264.5848.
13. Van der Bergh W., van der Schaaf I., van Gijn J. The spectrum of presentations of venous infarction caused by deep cerebral vein thrombosis. Neurology. 2005;65;192–196. DOI: 10.1212/01.wnl.0000179677.84785.63.
14. Luo Y., Tian X., Wang X. Diagnosis and Treatment of Cerebral Venous Thrombosis: A Review. Front Aging Neurosci. 2018;10:2. DOI: 10.3389/fnagi.2018.00002.
15. Brazis P., Madward J., Biller H. Topical diagnosis in clinical neurology. M.: MEDpress-inform. 2009 (in Russ.).
16. Schmidt T.E., Pronin I.N., Kazantsev K.Yu. et al. CLIPPERS Syndrome. Neurology, neuropsychiatry, psychosomatics. 2018;10(2):76–82 (in Russ.). DOI: 10.14412/2074-2711-2018-2-76-82.
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