A Case of Cerebral Venous Thrombosis 
                        Associated with Minimal Change Nephrotic Syndrome

J Korean Neurol Assoc > Volume 17(2); 1999 > Article

Journal of the Korean Neurological Association 1999;17(2): 289-293.

뇌정맥혈전증을 동반한 미세변화 신증후군 1례

전성철, 최 낙 천, 윤 혜 정, 김 태 유, 곽 준 혁, 홍 준 기, 임 병 훈

경상대학교 의과대학 신경과학교실, 경상대학교 신경과학연구소 경상대학교 의과대학 신경과학교실, 경상대학교 신경과학연구소 경상대학교 의과대학 신경과학교실, 경상대학교 신경과학연구소 경상대학교 의과대학 신경과학교실

A Case of Cerebral Venous Thrombosis Associated with Minimal Change Nephrotic Syndrome

Seong-Cheol Jeon, M.D., Nack-Cheon Choi, M.D., Hae-jeong Yun, M.D., Tae-Yu Kim, M.D.,Jun-Hyeon Goak, M.D., Jun-Gi Hung, M.D., Byeong Hoon Lim, M.D.

Department of Neurology, Gyeongsang National University College of Medicine Gyeongsang Institute for Neurosciences, 92 Chilam-dong Chinju 660-702 Republic of Korea

Abstract

Nephrotic syndrome causes a hypercoagulable state, leading to both venous and arterial thrombosis. Thromboembolic events occur frequently in patients with nephrotic syndrome. However, central venous thrombosis occurs less frequently as a complication of minimal change nephrotic syndrome. The pathogenic mechanisms are not yet unclear, but various alterations in coagulant and anti-coagulant factors may be responsible. We report a case of cerebral venous thrombosis associated with minimal change nephrotic syndrome. A 27-year-old man was admitted due to sudden, severe headache with nausea and vomiting. He complained of a continuous throbbing-type headache in bifrontal area. One month prior to the symptoms, he was diagnosed as having nephrotic syndrome based on clinical manifestations and biopsy findings. The routine laboratory findings showed that he had hyperlipidemia, hypoalbuminemia and proteinuria. In clotting factor analysis, fibrinogen, factor VII, VIII and von Willebrand factor were increased and factor XII, antithrombin III and protein S were decreased. The unenhanced brain CT scan showed a triangle-shape high density in a superior sagittal sinus and gadolinium enhanced brain MRI showed unenhanced blood clot in a superior sagittal sinus. Initial brain MR venography showed a lack of filling of a superior sagittal sinus and poor visualization of cortical veins. Key Wards : Central venous thrombosis, Minimal change nephrotic syndrome, MRI, MR venography