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Case No. 392
2015-12-01~2015-12-31
출제자 : 강경미
Hit : 360
| Period | 2015-12-01~2015-12-31 |
|---|---|
| Diagnosis | Deep vein thrombosis |
| Clinical information | F/34 C.C> 두통, 구토, 구역, 5일전부터 |
| Discussion | **Terminology Thrombotic occlusion of deep cerebral veins Usually affects both internal cerebral v +/- VOG, SS May occur in broader setting of widespread deep sinus thrombosis Venous stroke : 1-2% of strokes, ICV stroke : 10% of venous strokes **Imaging Best choice : CECT +/- CTV venogram CT Hyperdense ICV +/- bithalamic hypodensity Variable loss of deep G-W interfaces +/- petechial hemorrhage MR Clot hypointense, “blooms” on T2* DDx : nonvenous ischemia, neoplasm, toxic/metabolic **Etiology No cause identified in 20-25% of cases Wide spectrum of causes (> 100 identified) Trauma, infection, inflammation Pregnancy, oral contraceptives Metabolic (dehydration, thyrotoxicosis, cirrhosis, etc.) Hematological (coagulopathy) Collagen-vascular disorders (e.g., APLA syndrome) Vasculitis (e.g., Behçet) Drugs (androgens, ecstasy) Ulcerative colitis **Treatment Heparin ± rTPA Endovascular thrombolysis Reference> Diagnostic Imaging: Brain, Osborn et al, Amirsys, 2009 |
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Semi-Correct Answer |