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Deep Cerebral Venous Thrombosis: An Illustrative Case with Reversible Diencephalic Dysfunction

  • David J. Gladstone (a1), Frank L. Silver (a2) (a3), Robert A. Willinsky (a1) (a4), Felix J. Tyndel (a2) and Richard Wennberg (a5)...

Abstract:

Objectives:

Meige syndrome is a movement disorder that includes blepharospasm and oromandibular dystonias. Its etiology may be idiopathic (primary) or it may arise secondary to focal brain injury. Acute respiratory distress as a feature of such dystonias occurs infrequently. A review of the literature on Meige syndrome and the relationship between dystonias and respiratory compromise is presented.

Methods:

A 60-year-old woman suffered a cerebral anoxic event secondary to manual strangulation. She developed progressive blepharospasm combined with oromandibular and cervical dystonias. Neuroimaging demonstrated bilateral damage localized to the globus pallidus. Years later, she presented to the emergency department in intermittent respiratory distress associated with facial and cervical muscle spasms.

Results and conclusions:

Increasing frequency and severity of the disorder was noted over years. The acute onset of respiratory involvement required intubation and eventual tracheotomy. A partial therapeutic benefit of tetrabenazine was demonstrated.

RÉSUMÉ: Objectifs:

La moelle épinière est impliquée dans la sarcoïdose chez seulement 0.43% des patients atteints de cette maladie. Il y a habituellement des lésions systémiques avant l'apparition de lésions de la moelle épinière. Nous présentons un cas de lésion sarcoïdosique intramédullaire isolée, ce qui représente un défi diagnostique et thérapeutique. Nous revoyons le cas et nous présentons une revue de la littérature en soulignant le mode de présentation, le diagnostic et le traitement.

Méthodes:

Nous revoyons le cas d'un patient porteur d'un granulome sarcoïdosique isolé de la moelle épinière cervicale. L'histoire médicale pertinente et les données de l'examen physique ont été tirés du dossier du patient ainsi que d'une entrevue avec le patient. Nous présentons l'investigation biochimique, radiologique et anatomopathologique.

Résultats et conclusions:

Quatorze patients porteurs d'une sarcoïdose localisée uniquement à la moelle épinière ont été rapportés dans la littérature. La chirurgie a un rôle à jouer dans le diagnostic et la corticothérapie constitue la base du traitement.

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Copyright

Corresponding author

Cognitive Neurology Unit, Room A421, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada

References

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1. Bousser, MG, Barnett, HJM. Cerebral venous thrombosis. In: Barnett, HJM, Mohr, JP, Stein, BM, Yatsu, FM, eds. Stroke: pathophysiology, diagnosis, and management. 3rd Ed. Philadelphia: Churchill Livingstone, 1998: 623648.
2. Crawford, SC, Digre, KB, Palmer, CA, Bell, DA, Osborn, AG. Thrombosis of the deep venous drainage of the brain in adults: analysis of seven cases with review of the literature. Arch Neurol 1995; 52: 11011108.
3. Baumgartner, RW, Landis, T. Venous thalamic infarction. Cerebrovasc Dis 1992; 2: 353358.
4. Murray, BJ, Llinas, R, Caplan, LR, Scammell, T, Pascual-Leone, A. Cerebral deep venous thrombosis presenting as acute micrographia and hypophonia. Neurology 2000; 54: 751753.
5. Kim, KS, Walczak, TS. Computed tomography of deep cerebral venous thrombosis. J Comput Assist Tomogr 1986; 10(3): 386390.
6. Lafitte, F, Boukobza, M, Guichard, JP, et al. Deep cerebral venous thrombosis: imaging in eight cases. Neuroradiology 1999; 41(6): 410418.
7. Bell, DA, Davis, WL, Osborn, AG, Harnsberger, HR. Bithalamic hyperintensity on T2-weighted MR: vascular causes and evaluation with MR angiography. Am J Neuroradiol 1994; 15: 893899.
8. Keller, E, Flacke, S, Urbach, H, Schild, HH. Diffusion- and perfusion-weighted magnetic resonance imaging in deep cerebral venous thrombosis. Stroke 1999; 30(5): 11441146.
9. Hsu, LC, Lirng, JF, Fuh, JL, et al. Proton magnetic resonance spectroscopy in deep cerebral venous thrombosis. Clin Neurol Neurosurg 1998; 100: 2730.
10. Bousser, MG. Cerebral venous thrombosis: nothing, heparin, or local thrombolysis? Stroke 1999; 30: 481483.
11. Einhaupl, KM, Villringer, A, Meister, W, et al. Heparin treatment in sinus venous thrombosis. Lancet 1991; 338: 597600.
12. De Bruijn, SFTM, Stam, J, for the Cerebral Venous Sinus Thrombosis Group. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke 1999; 30: 484488.
13. Smith, AG, Cornblath, WT, Deveikis, JP. Local thrombolytic therapy in deep cerebral venous thrombosis. Neurology 1997; 48: 16131619.
14. Frey, JL, Muro, GJ, McDougall, CG, Dean, BL, Jahnke, HK. Cerebral venous thrombosis: combined intrathrombus rtPA and intravenous heparin. Stroke 1999; 30: 489494.
15. Martinelli, I, Sacchi, E, Landi, G, et al. High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N Engl J Med 1998; 338: 17931797.
16. De Bruijn, SFTM, Stam, J, Koopman, MMW, Vanderbroucke, JP, for the Cerebral Venous Sinus Thrombosis Study Group. Case-control study of risk of cerebral sinus thrombosis in oral contraceptive users who are carriers of hereditary prothrombotic conditions. Br Med J 1998; 316: 589592.
17. Haley, EC, Brashear, HR, Barth, JT, Cail, WS, Kassell, NF. Deep cerebral venous thrombosis: clinical, neuroradiological, and neuropsychological correlates. Arch Neurol 1989; 46: 337340.

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