PDF(Pubmed)
Abstract：
Cerebral venous thrombosis can result from hypercoagulation, either genetic or acquired. Hyperhomocysteninemia was previously thought to be linked with thrombophilia, although this is still controversial to this present day. In recent years, there has been a notable surge in the recreational use of nitrous oxide, which could potentially lead to hyperhomocysteinemia. We present a case of a 19-year-old female who was diagnosed with cerebral venous thrombosis with intracerebral hemorrhage. She had a history of nitrous oxide abuse, which is known to cause dysfunction of vitamin B12. Additionally, we conducted a literature review of cerebral venous thrombosis following nitrous oxide usage. Investigation showed that her serum vitamin B12 level was <100 pg/mL (reference range 197-771 pg/mL), and homocysteine level was 100.6 µmol/L (reference range 5.0-15.0 µmol/L). After receiving a vitamin B12 supplement, both serum vitamin B12 and homocysteine levels returned to normal. No other risk factors for thrombophilia were detected. Previously reported cases predominantly demonstrated hyperhomocysteinemia. The most likely mechanism of her cerebral venous thrombosis was hyperhomocysteinemia due to vitamin B12 deficiency caused by nitrous oxide abuse. This finding supports the hypothesis that hyperhomocysteinemia can induce cerebral venous thrombosis.
摘要：
脑静脉血栓形成可由高凝引起，要么是遗传的，要么是后天的。以前认为高同型半胱氨酸血症与血栓症有关，尽管这至今仍有争议。近年来,一氧化二氮的娱乐使用显着激增，这可能会导致高同型半胱氨酸血症。我们介绍了一例19岁的女性，她被诊断为脑静脉血栓形成伴脑出血。她有氧化亚氮滥用史,已知会导致维生素B12功能障碍。此外,我们对一氧化二氮使用后脑静脉血栓形成进行了文献综述.调查显示，她的血清维生素B12水平<100pg/mL（参考范围197-771pg/mL），同型半胱氨酸水平为100.6µmol/L（参考范围5.0-15.0µmol/L）。接受维生素B12补充剂后，血清维生素B12和同型半胱氨酸水平均恢复正常。未检测到其他易栓症的危险因素。以前报道的病例主要表现为高同型半胱氨酸血症。她的脑静脉血栓形成的最可能机制是高同型半胱氨酸血症，这是由于一氧化二氮滥用引起的维生素B12缺乏所致。这一发现支持高同型半胱氨酸血症可以诱导脑静脉血栓形成的假设。
