Nadir bir İnme: Serebral Venöz-Sinüs Trombozu; Acil Serviste bir Vaka Serisi ve Literatür Derlemesi

Abstract

Serebral venöz sinüs trombozu (SVST) nadir görülen ancak akut ve yaşamı tehdit eden bir hastalıktır. Bu çalışmada, üçüncü basamak bir hastanenin acil servisinde tanı alan 10 hastalık SVST vaka serisini sunuyoruz. Hastaların demografik özellikleri, SVST etiyolojileri, özgeçmişlerindeki tanısal özellikler, radyolojik bulgular ve prognoz hastanede yattıkları süre boyunca kaydedildi. Hastaların ortanca yaşı 32 idi. Yarısı kadındı. Üç hastada orta kulak iltihabı, diğer üç hastada gebelik, lohusalık ve hormonal kontraseptif olduğu biliniyordu. Bir hastada kronik enflamatuvar hastalık mevcuttu ve bir hastada tromboz idiyopatikti. Hastaların biri hariç tümünde baş ağrısı vardır. Tanı aracı manyetik rezonans venografi idi ve tüm hastalarda transvers sinüs tıkalıydı. Tüm hastalar nöroloji bölümünde yatarak antikoagülan tedavi aldı, 9 hasta şifa ile taburcu edildi, 1 hasta öldü. Özellikle genç hastalarda ve trombotik risk faktörleri olan hastalarda acil servis klinisyenleri daha dikkatli olmalıdır. Hormonal kontraseptif önlenebilir bir majör risk faktörüdür. Ancak gebelik ve doğum sonrası dönem başlı başına bir trombotik risk faktörüdür. Otitis media gibi intrakraniyal enfeksiyonlar yayılarak serebral ven trombozuna neden olabilir. Manyetik rezonans venografi, SVST için en başarılı tanı aracıdır.

Keywords

• Sinüs ven trombozu
• acil tıp
• baş ağrısı

A rare stroke: Cerebral Venous-Sinus Thrombosis; A Case Series Analysis Presented to Emergency Department and Review of the Literature

Abstract

ABSTRACT Cerebral venous sinus thrombosis (CVST) is a rare but acute and life-threatening disease. In this study, we present a case series of 10 patients with CSVT diagnosed in the emergency department of a tertiary hospital. Demographic characteristics, CVST etiologies, diagnostic characteristics in their history, radiological signs and prognosis were recorded during their hospitalization. The median age of the patients was 32 years. Half of the patients were women. It was known that three patients had otitis media, and the other three patients had pregnancy, puerperium and hormonal contraceptives. One patient had chronic inflammatory disease and one patient had idiopathic thrombosis. All but one of the patients had headache. The diagnostic tool was magnetic resonance venography and all patients had transverse sinus occlusion. All patients received anticoagulant treatment in the neurology department, 9 patients were discharged with good recovery, 1 patient died. Emergency clinicians should be more careful, especially in young patients and patients with thrombotic risk factors. Hormonal contraceptives are a major preventable risk factor. However, pregnancy and the postpartum period are thrombotic risk factors on their own. Intracranial infections such as otitis media may spread and cause cerebral vein thrombosis. Magnetic resonance venography is the most successful diagnostic tool for SSVT.

Keywords

• Venous sinus thrombosis
• emergency medicine
• headache

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