title: Sturge-Weber syndrome with intracerebral hemorrhage: a case report.
abstract: BACKGROUND
  Sturge-Weber syndrome (SWS) is a rare congenital disease that affects the brain, skin, and eyes, and is a sporadically occurring neurocutaneous syndrome that affects intracerebral veins, which is associated with venous thrombosis. However, intracranial hemorrhage in patients with SWS is rare. We herein report a rare case of SWS with intracerebral hemorrhage derived from sinus thrombosis.
  
  
  METHODS
  A 62-year-old man suddenly fell into a coma and was admitted to our hospital. His neurological status was assessed as GCS 6 (E1V1M4) with right-sided hemiparesis. At birth, he had a right-sided facial port-wine stain typical of SWS that involved the ophthalmic division of the trigeminal nerve. Laboratory findings showed that he was dehydrated, and his serum D-dimer concentration was increased. Computed tomography revealed left thalamic hemorrhage with acute hydrocephalus and cortical calcification in the right occipital lobe. Magnetic resonance imaging displayed a vascular malformation of the right cerebral hemisphere consistent with SWS. Magnetic resonance venography showed steno-occlusion of the superior sagittal sinus, straight sinus, and left internal cerebral vein (ICV). Emergency ventricular drainage was performed. Seven days after surgery, his consciousness improved to GCS 14 (E4V4M6). Rehydration therapy was performed to prevent sinus thrombosis.
  
  
  RESULTS
  His postoperative course was uneventful. Sudden congestion of the left ICV may have caused left thalamic hemorrhage.
  
  
  CONCLUSIONS
  SWS with major sinus occlusion needs to be diagnosed with utmost caution in order to allow for preoperative neurological and radiological assessments.
authors: Department of Neurosurgery, Iwaki Kyoritsu Hospital, 16 Kusehara, Uchigo Mimaya-machi, Iwaki, Fukushima 973-8555 Japan.
authors: Masashi
authors: M
authors: Chonan
authors: Department of Neurosurgery, Iwaki Kyoritsu Hospital, 16 Kusehara, Uchigo Mimaya-machi, Iwaki, Fukushima 973-8555 Japan.
authors: Yasuhiro
authors: Y
authors: Suzuki
authors: Department of Neurosurgery, Iwaki Kyoritsu Hospital, 16 Kusehara, Uchigo Mimaya-machi, Iwaki, Fukushima 973-8555 Japan.
authors: Shinya
authors: S
authors: Haryu
authors: Department of Neurosurgery, Iwaki Kyoritsu Hospital, 16 Kusehara, Uchigo Mimaya-machi, Iwaki, Fukushima 973-8555 Japan.
authors: Shoji
authors: S
authors: Mashiyama
authors: Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan.
authors: Teiji
authors: T
authors: Tominaga
keywords: Intracerebral hemorrhage; Sinus thrombosis; Sturge–Weber syndrome