Abstract:
Thyroid dysfunction is a well-known cause of cerebral venous sinus thrombosis (CVST), but most reports have focused on CVST associated with hyperthyroidism, with only a few mentioning CVST associated with hypothyroidism. Subclinical hypothyroidism, characterized by thyroid hormone levels within reference values but elevated thyroid-stimulating hormone, can also cause CVST. Here, we present a case of CVST associated with subclinical hypothyroidism. A 48-year-old man with headache, nausea, and left-sided motor weakness was admitted to our hospital, with a history of economy-class syndrome. Magnetic resonance imaging revealed occlusion of the superior sagittal sinus, right transverse sinus, and right sigmoid sinus. Digital subtraction angiography (DSA) confirmed CVST from the right common carotid artery, revealing abnormal staining of the thyroid gland. The patient was serologically in a state of subclinical hypothyroidism. Consequently, the patient was diagnosed with CVST associated with subclinical hypothyroidism. Anticoagulation therapy was initiated shortly after admission. CVST gradually resolved, and the affected sinuses were recanalized. Paraplegia improved, and the patient was discharged home 19 days after admission with a modified Rankin scale of 1. Subclinical hypothyroidism can induce CVST, underscoring the importance of screening for thyroid function in CVST patients, even without apparent thyroid dysfunction symptoms. DSA findings are valuable for diagnosing thyroid disease.
摘要:
甲状腺功能障碍是众所周知的脑静脉窦血栓形成(CVST)的原因,但是大多数报道都集中在与甲状腺功能亢进相关的CVST上,只有少数人提到CVST与甲状腺功能减退有关。亚临床甲状腺功能减退症,甲状腺激素水平在参考值范围内,但甲状腺刺激激素升高,也可能导致CVST。这里,我们介绍一例与亚临床甲状腺功能减退症相关的CVST.一位48岁的头痛患者,恶心,左侧运动无力被送进了医院,有经济舱综合症的历史。磁共振成像显示上矢状窦闭塞,右横窦,和右乙状窦.数字减影血管造影(DSA)证实了右侧颈总动脉的CVST,揭示甲状腺的异常染色。患者在血清学上处于亚临床甲状腺功能减退症状态。因此,患者被诊断为与亚临床甲状腺功能减退症相关的CVST.入院后不久开始抗凝治疗。CVST逐渐解决,受影响的鼻窦被再通。截瘫好转,患者入院后19天出院,改良Rankin评分为1。亚临床甲状腺功能减退症可诱发CVST,强调CVST患者甲状腺功能筛查的重要性,即使没有明显的甲状腺功能障碍症状。DSA检查结果对甲状腺疾病的诊断有价值。