SİBEL GÜLER, Çiğdem DENİZ, Ufuk UTKU, SEZGİN KEHAYA

A case of cerebral venous thrombosis accompanying with intracranial hypotension: Headache that changing character

Spontan intrakraniyal hipotansiyon literatürde ilk kez Schaltenbran tarafından tanımlanmıştır. Subdural hemoraji ve serebral venöz tromboz gibi ciddi komplikasyonlar nadir olarak gözlenmektedir. Kırk yaşında erkek hasta yaklaşık dokuz ay evvel sağ kolda belirgin olan ve son üç aydır giderek artan güçsüzlük yakınmaları ile değerlendirildi. Servikal MRGde C2 düzeyinde şüpheli demiyelinizan plak görülmesi üzerine lomber ponksiyon uygulandığı belirtildi. Lomber ponksiyon incelemesinden sonra ortostatik baş ağrısı gelişen olgunun 10. günde ise jeneralize tonik klonik epileptik nöbet kliniği geliştiği izlendi. Kraniyal MR venografde sağ transvers sinüs ve süperior sagittal sinüste tromboz ve intrakraniyal hipotansiyona bağlı pakimenenjit bulguları birarada gözlendi. Literatürde bu iki olayın birlikteliğine çok nadir olarak rastlanmaktadır. Tromboz hem venöz sinüsleri hem de kortikal venleri etkileyebilir. Spontan intrakraniyal hipotansiyon serebral venöz tromboz için risk faktörüdür, fakat olguların sadece %2sinde bir komplikasyon olarak gelişebilir. Olgumuzun da bu nadir birliktelik dolayısıyla literatüre katkı sağladığı düşünülmektedir.

İntrakranyal hipotansiyon ile birliktelik gösteren serebral venöz tromboz olgusu: Karakter değiştiren baş ağrısı

Spontaneous intracranial hypotension was frst described by Schalternbarn. Severe complications like cerebral venous throm- bosis and subdural hemorrhage are seldomly seen. A 40-year-old man was examined for weakness of right arm started 9 months earlier and aggravated in last 3 months. He was undergo a lumbar punction because of a demyelinating plaque at C2 level in MRI. After 10 days of lumbar punction he experienced a generalised tonic clonic seizure. At cranial MRI and venogra- phy thrombosed superior sagittal and right transverse sinus and image of pachymeningitis, caused by intracranial hypotension were observed. Coincidence of these two situations together was seldomly found at literature. Trombosis can both efect the sinuses and cortical veins. Spontaneous intracranial hypotension is a risk factor for CVT, but at only 2% CVT is seen as a complication. We think that our case can add addition to literature by having this coincidence.

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