Abstract
A 76-year-old Japanese female with type 2 diabetes was admitted to our hospital with impaired consciousness and hyperglycemia. She was under treatment with glimepiride and voglibose. On admission, she presented with confusion and sensory aphasia. Her HbA1c level was 12.8 %, and her random plasma glucose level was 330 mg/dl. Magnetic resonance (MR) imaging and MR venography showed a left transverse sinus thrombosis. Anticoagulant therapy was administered, the patient was rehydrated and insulin was administered. The sensory aphasia improved three days after admission, and did not recur thereafter. Dehydration, abnormal hemostasis and decreased fibrinolytic activity due to chronic hyperglycemia could have caused the cerebral venous thrombosis. Inspection of MR images acquired at a later stage showed hypoplasia of the left transverse venous sinus, and the thrombus was thought to have formed in this region. When patients with poorly controlled diabetes mellitus present with neuropsychiatric symptoms, then the possible occurrence of transverse sinus thrombosis should be considered.
