title: [Refractory Evans syndrome complicated with transverse sinus thrombosis].
abstract: A 29-year-old woman was diagnosed as having Evans syndrome in 2002 and underwent a splenectomy for the refractory status of the disorder in May 2004. One and a half months after the operation, her platelet count again decreased due to relapse, and she was then prescribed with high dose dexamethasone (38 mg/day x 4 days). Five days after the medication, she complained of a severe headache and then fell into coma, even though her platelet count had risen to 8 x 10(4)/mm3. Computer tomography scan of the brain showed severe edema with a massive hemorrhage in left temporooccipital lobe, which was compatible with cerebral transverse sinus thrombosis. After resection of the damaged brain, her level of consciousness gradually recovered, although visual disturbance and moderate hemiplegia remained. This is the fourth case of idiopathic thrombocytopenic purpura which was complicated with sinus thrombosis in the literature.
authors.affiliation: Department of Internal Medicine, Ebina General Hopital.
authors.forename: Masao
authors.initials: M
authors.lastname: Hagihara
authors.forename: Shigeki
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kosuke
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suyama
authors.forename: Koji
authors.initials: K
authors.lastname: Sato
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000628:therapy; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000628:therapy; D012008:Recurrence; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013156:Splenectomy; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D003907:Dexamethasone