title: [Case of cerebral venous thrombosis causing refractory intracerebral hemorrhage].
abstract: Cerebral venous thrombosis is an uncommon disease characterized by expansive cerebral edema, venous infarction and massive intracerebral hemorrhage. Magnetic resonance imaging and angiography are useful for diagnosis of cerebral venous thrombosis. A 54-year-old man was admitted with headache, vomiting and right hemiparesis. Computed tomography (CT) revealed subcortical hematoma in the left parietal lobe. Digital subtraction angiography (DSA) demonstrated occlusion of the left Labbé vein with dilation of cortical veins and deep cerebral veins. He also suffered from pulmonary embolization and deep vein thrombosis in the lower extremities. Anticoagulant and thrombolytic agents were administered, then respiratory condition and hemiparesis were improved. However, his condition deteriolated 7 months after the initial attack. CT revealed huge subcortical hematoma in the same site. He underwent craniotomy and intracerebral hematoma was evacuated during treatment with vitamin K. His symptom gradually improved and he was discharged with moderate disability 2 months after operation. Dicision of surgical treatment is difficult because there is a risk of rebleeding due to thrombolytic therapy and progressive venous congestion. Since anticoagulant and thrombolytic therapy are inevitable, surgical indication for refractory intracerebral hemorrhage associated with cerebral venous thrombosis should be considered carefully.
authors.affiliation: Department of Neurosurgery, Fuji City General Hospital.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kato
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Mori
authors.forename: Koujirou
authors.initials: K
authors.lastname: Seki
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Noda
authors.forename: Satoru
authors.initials: S
authors.lastname: Morooka
authors.forename: Masayo
authors.initials: M
authors.lastname: Morita
authors.forename: Toshihide
authors.initials: T
authors.lastname: Tanaka
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Abe
mesh_terms: D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D003952:Diagnostic Imaging; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014812:Vitamin K / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D014812:Vitamin K