鉄欠乏性貧血が原因と考えられた脳皮質静脈血栓症の1例

抄録

A 51-year-old woman was brought to our hospital with a major complaint of headache. Computed tomography (CT) showed a right temporal subcortical hemorrhage. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) did not show any abnormalities. Laboratory evaluation on admission showed a severe iron deficiency anemia (IDA) due to myoma uteri. Therefore, the patient was admitted to our hospital, and a conservative treatment was administered to lower the blood pressure. However, 4 hours after admission, she became comatose, and CT revealed an increased hematoma size and signs of herniation. External decompression was performed and white thrombosis was observed in the superficial middle cerebral vein (SMCV). The patient was treated with heparin and warfarin, and she was discharged with only left spatial neglect on hospital day 119. IDA induces thrombopoiesis, which is thought to be associated with a hypercoagulable state and microcytosis causing reduced red cell deformability and increased viscosity. This situation induced cerebral venous thrombosis.