一个不寻常的脑静脉鼻血栓与负的D-二次体模仿巨细胞关节炎的异常病例
Ozair Ali1, Rahim Abbas1, Neha Shaikh2
1Internal Medicine, Barnsley Hospital NHS Foundation Trust, Barnsley, GBR.
Cureus
|November 10, 2025
概括
大脑静脉鼻血栓塞 (CVST) 可以模仿其他疾病,即使是负的D-二次数. 这一案例凸显了考虑在老年人中使用CVST治疗的时间性头痛和下疼痛.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 大脑静脉鼻血栓塞 (CVST) 是一种罕见但严重的疾病,具有多种症状.
- 在CVST诊断延迟可能导致严重的神经结果.
- CVST症状可以模仿动脉中风或其他内病理,使诊断复杂化.
研究的目的:
- 报告一种罕见的广泛CVST病例,最初被误诊为巨细胞动脉炎 (GCA).
- 强调在特定的患者陈述中考虑CVST的重要性,无论D-二次体结果如何.
- 突出CVST的诊断挑战和管理策略.
主要方法:
- 一个62岁的男性患者的病例报告,患有广泛的CVST.
- 最初呈现时有部头痛和下疼痛,因疑似GCA而接受治疗.
- 诊断确认使用CT静脉图像和血栓性查.
主要成果:
- 广泛的CVST证实,尽管D-二聚合物和初始GCA治疗是负面的.
- 发现了阳性狼抗凝剂,表明血栓友风险因素.
- 患者开始使用华法林的长期抗凝治疗.
结论:
- 在50岁以上的患有时间性头痛和下疼痛的患者中,应考虑CVST,即使D-二次数是负的.
- 在CVST中可能存在高C-反应蛋白 (CRP),可能表明预后较差.
- 血栓友测试对于指导CVST未引起病例的抗凝血持续时间至关重要.
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