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患者男,57岁。于2008年10月出现嗜睡,伴记忆力减速。在当地医院行MRI检查,示双侧丘脑梗死(图1a),给予脱水、降低纤维蛋白原、抗血小板聚集、改善血液循环、神经营养等药物治疗,患者症状未见缓解,保守治疗后2周出院。2009年7月因症状进行性加重,再次入当地医院,复查MRI示梗死仍存在(图1b),MR静脉成像(MRV)示左侧横窦乙状窦显影差(图2a),MR动脉成像(MRA)示动脉期异常引流静脉影(图2b)。当地医院考虑静脉窦血栓可能性大,给予抗凝治疗后症状仍不缓解。2009年8月入哈尔滨医科大学第一医院,患者表现为嗜睡、表情淡漠、思维迟钝、有明显的人格改变及顺行性遗忘。患者既往无糖尿病、高血压、高血脂等危险因素。常规实验室检查及脑脊液
Male patient, 57 years old. Drowsiness appeared in October 2008 with slowed memory. In the local hospital MRI examination showed bilateral thalamic infarction (Figure 1a), given dehydration, fibrinogen, anti-platelet aggregation, improve blood circulation, neurotrophic and other drug treatment, the patient’s symptoms did not ease, 2 weeks after conservative treatment Discharged. In July 2009, due to progressive worsening of symptoms, they were re-admitted to a local hospital and MRI was found after review of MRI (Fig. 1b). MR venography (MRV) showed poor left sigmoid sinus devascularization (Fig. 2a) (MRA) showed abnormal arterial venous drainage (Figure 2b). Local hospitals consider the possibility of venous sinus thrombosis, given anticoagulant therapy is still not relieve symptoms. In 2009 August into Harbin Medical University First Hospital, patients showed drowsiness, apathy, slow thinking, significant personality change and the consequent forgetfulness. Patients without previous diabetes, hypertension, hyperlipidemia and other risk factors. Routine laboratory tests and cerebrospinal fluid