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Superior sagittal sinus thrombosis induced by thyrotoxicosis. Case report
1Department of Neurosurgery, Chang Gung University, Kaohsiung Medical Center, Taiwan.
Journal of Neurosurgery
|January 9, 2001
Summary
This study highlights a rare case of superior sagittal sinus thrombosis (SSS thrombosis) linked to Graves disease thyrotoxicosis. Successful thrombolysis was achieved despite coexisting intracranial hemorrhage.
Area of Science:
- Neurology
- Endocrinology
- Hematology
Background:
- Superior sagittal sinus thrombosis (SSS thrombosis) has diverse causes, including infections, vasculitis, hypercoagulable states, and pregnancy-related complications.
- Approximately 25% of SSS thrombosis cases are idiopathic, indicating potential unknown contributing factors.
Observation:
- A patient with Graves disease experienced a thyrotoxic phase complicated by SSS thrombosis.
- The patient presented with severe neurological symptoms including intracerebral hemorrhage, subarachnoid hemorrhage, seizure, and coma.
- Coexisting hematological abnormalities included elevated fibrinogen, low protein C activity, and atrial fibrillation.
Findings:
- The case demonstrates a potential association between thyrotoxicosis in Graves disease and the development of SSS thrombosis.
- Hypercoagulation and venous stasis associated with thyrotoxicosis may predispose individuals to SSS thrombosis.
- Successful thrombolytic therapy was administered despite the concurrent presence of SSS thrombosis and intracranial hemorrhage.
Implications:
- This case expands the known spectrum of conditions associated with SSS thrombosis.
- It suggests that patients with thyrotoxicosis and goiter may require heightened awareness for SSS thrombosis.
- The successful treatment highlights the feasibility of thrombolysis even in complex cases involving intracranial hemorrhage.