J Korean Neurol Assoc.  1999 Mar;17(2):289-293.

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

• Jeon SC
• Choi NC
• Yun HJ
• Kim TY
• Kwak JH
• Hong JG
• Lim BH

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.

Keyword

Central venous thrombosis; Minimal change nephrotic syndrome; MRI; MR venography

MeSH Terms

Adult
Antithrombin III
Biopsy
Brain
Factor VII
Factor XII
Fibrinogen
Gadolinium
Headache
Humans
Hyperlipidemias
Hypoalbuminemia
Magnetic Resonance Imaging
Nausea
Nephrosis, Lipoid*
Nephrotic Syndrome
Phlebography
Protein S
Proteinuria
Superior Sagittal Sinus
Thrombosis
Tomography, X-Ray Computed
Veins
Venous Thrombosis*
Vomiting
von Willebrand Factor
Antithrombin III
Factor VII
Factor XII
Fibrinogen
Gadolinium
Protein S
von Willebrand Factor