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• Vol.54 No.6
• CLINICA NEUROL, 54: 495−501, 2014
• Vol.54 No.6 contents

Case Report

Cerebral venous thrombosis as a complication of nephrotic syndrome
-A case report and literature review-

Hirotaka Iwaki, M.D.¹⁾²⁾, Shuichiro Neshige, M.D.¹⁾, Naoyuki Hara, M.D.¹⁾³⁾, Shinichi Takeshima, M.D.¹⁾, Kazuhiro Takamatsu, M.D.¹⁾ and Masaru Kuriyama, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Brain Attack Center Ota Memorial Hospital
²⁾Present address; Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine
³⁾Present address; Department of Neurology, Hiroshima City Hospital

We report two cases of cerebral venous thrombosis as a complication of nephrotic syndrome. No urine protein or kidney disease was noted in either case. The patients were diagnosed with nephrotic syndrome after admission to our hospital. Case 1: The patient was a 46-year-old man. He experienced headache and vomiting the day after he drank heavily. Contrast brain computed tomography (CT) and magnetic resonance imaging (MRI) revealed a defect in the transverse sinus, straight sinus, and superior sagittal sinus. His blood was hemo-concentrated, and blood test results indicated high D-dimer and fibrinogen levels and decrease of antithrombin III. Case 2: The patient was an 89-year-old woman. After the diarrhea lasted suffering from ischemic colitis, she developed left hemiplegia and headache. Brain CT revealed hematoma in the subcortical region of the right frontal lobe and a high signal in the straight sinus. The superior sagittal sinus showed high-signal intensity on T₁-weighted MRI and mild high-signal intensity on T₂-weighted MRI. High fibrinogen levels were detected in the blood. Patients with nephrotic syndrome have a thrombotic tendency; both venous thrombosis and arterial thrombosis may occur. In the literature, the number of published cases of cerebral venous thrombosis was 10-fold that of cerebral artery thrombosis as a complication of nephrotic syndrome in individuals aged ‹20 years. In adults, however, the number of cerebral venous thrombosis was 2-fold that of cerebral artery thrombosis cases were reported. Nephrotic syndrome shows a thrombotic tendency, but cerebral venous thrombosis may develop as a result of another thrombotic factor. Management of life along with the conventional treatment of nephrotic syndrome is important.
Full Text of this Article in Japanese PDF (3018K)

(CLINICA NEUROL, 54: 495−501, 2014)
key words: cerebral venous thrombosis, nephrotic syndrome, thrombotic tendency, antithrombin III, superior sagittal sinus thrombosis

(Received: 22-Sep-13)