Congested, Cyanotic Tongue in Patient with Cerebral Venous Thrombosis

部分血液癌症的病人具有腦部靜脈栓塞的危險性，但只有少數腦實質腫瘤會直接造成腦部血管的壓迫，造成腦部靜脈栓塞的現象。癌症病患可能是因基因突變而造成血液凝固異常，有些則是接受化療和電療等因素造成。腦部靜脈栓塞病患會以各種不同的症狀來表現。我們因此提出一個案例報告，有關一位剛接受合併化療（cisplatin和5FU）和電療的鼻咽癌病患，因腦部靜脈栓塞而產生癲癇、舌頭發紺腫脹、味覺異常症狀。此病患的靜脈栓塞位於上矢狀竇枕部，右側之橫竇(transverse sinus)和乙狀竇(sigmoid sinus)。病患有異常的舌頭發紺腫脹、異常味覺的表現並非一般腦部靜脈栓塞的症狀。經過抗凝血劑治療後症狀有明顯改善，推測為右側頸靜脈回流異常造成。

關鍵字

腦靜脈塞血栓；同時合用化學及放射治療；充血及紫紺性舌；鼻咽癌

並列摘要

Cerebral venous thrombosis may develop in patients with hematologic cancer or solid tumors and can cause direct compression of vessels. Prothrombotic mutations in cancer patients play an important role in venous thrombosis. Patients with cerebral venous thrombosis may present with various symptoms. We report on a 43 year-old woman with nasopharyngeal cancer who developed cerebral venous thrombosis. She presented with seizures and the atypical sign of a thickened, cyanotic tongue. She received concurrent chemotherapy and radiotherapy (CCRT) for nasopharyngeal cancer prior to admission. Computed tomography of the brain, revealed a thrombus at the confluence of the superior sagittal sinus. The right transverse and sigmoid sinuses were also involved. The patient also had a right side hemicranial headache, vomiting and hyperesthesia in her congested, cyanotic tongue. The patient was treated initially with intravenous heparin and her symptoms improved 10 days after. Occlusion of venous sinuses remained after treatment but the patient was symptom free.

並列關鍵字

cerebral venous thrombosis ； congested cyanotic tongue ； concurrent chemotherapy and radiotherapy ； nasopharyngeal cancer

國際替代計量

Congested, Cyanotic Tongue in Patient with Cerebral Venous Thrombosis

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