A Case of Cerebral Venous Thrombosis in a Patient with Graves' Disease

Bo Ra Kim; Jung Hwa Jung; Jong Ryeal Hahm; Jaehoon Jung; Hee Jung Park; Soo Kyoung Kim

doi:10.7180/kmj.2016.31.2.179

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Kim, Jung, Hahm, Jung, Park, and Kim: A Case of Cerebral Venous Thrombosis in a Patient with Graves' Disease

Case Report

Kosin Medical Journal 2016;31(2):179-183.

Published online: 20 January 2016

DOI: https://doi.org/10.7180/kmj.2016.31.2.179

A Case of Cerebral Venous Thrombosis in a Patient with Graves' Disease

Bo Ra Kim¹, Jung Hwa Jung^1,², Jong Ryeal Hahm^1,², Jaehoon Jung^1,², Hee Jung Park¹, Soo Kyoung Kim^1,^2,

¹Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongsangnam-do, Korea

²Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Gyeongsangnam-do, Korea

Corresponding Author: Soo Kyoung Kim, Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, 79, Gangnam-ro, Jinju-si, Gyeongsangnam-do 52727, Korea TEL: +82-55-750-8874 FAX: +82-55-758-9122 E-mail: 9854008@naver.com

Received 14 July 201517 July 2015 Accepted 21 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Superior sagittal sinus thrombosis is an uncommon disease, and 25% of cases are considered to be idiopathic. Hypercoagulability, local bloodstream stasis, and vessel wall abnormalities may contribute to the development of this condition. The thyrotoxic phase of Graves' disease is associated with venous thrombosis caused by hypercoagulability, which is in turn induced by increased levels of homocysteine and factor VIII and decreased fibrinolytic activity. Here, we report the case of a 39-year-old male who presented with superior sagittal sinus thrombosis and concomitant hyperthyroidism.

Keywords: Cerebral venous thrombosis, Thyrotoxicosis, Protein C Deficiency

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Fig. 1.

Fluid-attenuated inversion recovery (FLAIR, A) and diffusion-2 weighted MR images(DWI, B) demonstrate multiple hyperintense lesions in both high frontal cortices (arrows). The lesions are more clearly demonstrated on DWI (B) than on FLAIR image (A).

Fig. 2.

Brain computed tomography (CT) angiography shows segmental 2 occlusion of the superior sagittal sinus due to thrombosis (arrows).

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