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Pseudotumor cerebri and lung cancer-associated jugular vein thrombosis: Role of anatomical variations of torcular herophili

机译:假瘤脑梗塞术和肺癌相关的颈静脉血栓形成:Torcular Herophili解剖学变化的作用

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摘要

A 71-year-old male appeared at the facility complaining of disturbance of consciousness and bilateral papilledema. The laboratory test revealed anemia and coagulation abnormality. A physical examination and magnetic resonance imaging (MRI) of the brain with and without gadolinium showed no abnormalities. A lumbar puncture showed a high pressure, but a normal cerebrospinal fluid (CSF) cell count. Cerebral angiography showed no morphological abnormalities, but it revealed an asymmetric right dominant type of confluence of the sinuses with the partially-communicating left transverse sinus in the late phase. Furthermore, there was a delay in the cerebral circulation time (CCT). Subsequently, venography and ultrasonography revealed right internal jugular vein thrombosis associated with lung cancer. The patient recovered from the disturbance of consciousness immediately after an emergency ventriculoperitoneal shunt and anticoagulation therapy. This case was diagnosed as secondary pseudotumor cerebri (PTC). In order to facilitate the early detection of secondary PTC, it is important to take note of symptoms of intracranial hypertension with no remarkable intracranial lesions and to consider the possibility of PTC, especially in the patients with high risk factors for coagulopathy including lung cancer. Keywords: Cerebral circulation time, Confluence of sinuses (torcular Herophili), Idiopathic intracranial hypertension, Jugular vein thrombosis, Lung cancer, Pseudotumor cerebri
机译:A 71岁的男子出现在工厂抱怨意识和双侧视神经乳头水肿的干扰。实验室测试显示贫血及凝血功能异常。有和无钆大脑的身体检查和磁共振成像(MRI)均未见异常。腰椎穿刺显示出高的压力,但通常的脑脊髓液(CSF)细胞计数。脑血管造影显示无形态学异常,但它显示了一个非对称的右优势型与晚期部分相通左横窦的窦的汇合。此外,在脑循环时间(CCT)的延迟。随后,静脉造影和超声检查发现静脉血栓形成与肺癌相关的右颈内。患者从意识障碍恢复紧急脑室腹腔分流术和抗凝治疗后即可。这种情况下,诊断为次级假性脑瘤(PTC)。为了便于早期发现二次PTC的,要注意的颅内高压症状无明显颅内病变,并考虑PTC的可能性,尤其是在患者的高危险因素,凝血功能障碍,包括肺癌是非常重要的。关键词:脑循环时间,鼻窦的合流(torcular Herophili),特发性颅内压增高,颈静脉血栓形成,肺癌,假性脑瘤

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