上矢狀竇栓塞併雙側偏癱：病例報告

Superior Sagittal Sinus Thrombosis Causing Bilateral Hemiplegia : Case Report

孟乃欣(Nai-Hsin Meng) ； 王亭貴(Tyng-Guey Wang) ； 張權維(Chein-Wei Chang)

《中華民國復健醫學會雜誌》 26卷3期 (1998/09) Pp. 143-149

摘要

上矢狀竇栓塞為一少見之腦血管病變，臨床上常導致嚴重之神經併發症，如顱內壓增高、癲癇發作、單側或雙側偏癱等。本文報告一位罹患上矢狀竇栓塞的57歲男性，因兩側交替暫時性腦缺血發作及癲癇發作，經磁振血管造影診斷為上矢狀竇栓塞，而接受口服抗凝血劑治療。四個月後發生兩側出血性腦梗塞致雙側偏癱，主要影響四肢軀幹之運動及感覺功能，而顏面之運動、感覺、吞嚥、認知及語言等功能並未波及。發病迄今已逾兩年，神經功能無恢復跡象，且仍時有癲癇發作。本文就此患者產生上矢狀竇栓塞之原因做一探討，並作為臨床上診斷及治療之參考。

關鍵字

腦部靜脈竇栓塞 ； 腦中風

並列摘要

Superior sagittal sinus thrombosis is an uncommon stroke syndrome which may cause serious complications, including increased intracranial pressure, seizures or unilateral or bilateral hemiplegia with motor deficit more prominent in the lower limbs and proximal upper limbs. We present a 57-year-old male patient who had seizures and recurrent transient ischemic attacks in 1995. He was shown to have superior sagittal sinus thrombosis on magnetic resonance imaging and received oral anticoagulation therapy. Four months after initial treatment he had hemorrhagic infarctions over bilateral cerebral hemispheres and bilateral hemiplegia resulted. Little neurologic recovery was noted during the two-year follow up. The possible causes of the disease and the potential treatment regimen are reviewed and discussed.

並列關鍵字

cerebral sinus thrombosis ； stroke