title: [Cerebral venous thrombosis as a complication of nephrotic syndrome--a case report and literature review].
abstract: 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.
authors.affiliation: Department of Neurology, Brain Attack Center Ota Memorial Hospital.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iwaki
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Neshige
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takeshima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takamatsu
authors.forename: Masaru
authors.initials: M
authors.lastname: Kuriyama
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D020152:Antithrombin III Deficiency; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications* / Q000175:diagnosis; D054063:Superior Sagittal Sinus; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D005340:Fibrinogen