Progressive Ischemic Stroke Due to Thyroid Storm-Associated Cerebral Venous Thrombosis

Overview

Journal Am J Case Rep

Specialty General Medicine

Date 2017 Feb 24

PMID 28228636

Citations 5

Authors

Natsumi Tanabe

Eiji Hiraoka

Masataka Hoshino

Gautam A Deshpande

Kana Sawada

Yasuhiro Norisue

Jumpei Tsukuda

Toshihiko Suzuki

Affiliations

Soon will be listed here.

Abstract

BACKGROUND Cerebral venous thrombosis (CVT) is a rare but fatal complication of hyperthyroidism that is induced by the hypercoagulable state of thyrotoxicosis. Although it is frequently difficult to diagnose CVT promptly, it is important to consider it in the differential diagnosis when a hyperthyroid patient presents with atypical neurologic symptoms. CASE REPORT A 49-year-old Japanese female with unremarkable medical history came in with thyroid storm and multiple progressive ischemic stroke identified at another hospital. Treatment for thyroid storm with beta-blocker, glucocorticoid, and potassium iodide-iodine was started and MR venography was performed on hospital day 3 for further evaluation of her progressive ischemic stroke. The MRI showed CVT, and anticoagulation therapy, in addition to the anti-thyroid agents, was initiated. The patient's thyroid function was successfully stabilized by hospital day 10 and further progression of CVT was prevented. CONCLUSIONS Physicians should consider CVT when a patient presents with atypical course of stroke or with atypical MRI findings such as high intensity area in apparent diffusion coefficient (ADC) mapping. Not only is an early diagnosis and initiation of anticoagulation important, but identifying and treating the underlying disease is essential to avoid the progression of CVT.

Citing Articles

Association Between Thyrotoxicosis and Cerebral Venous Thrombosis.

Paccagnella M, Pizzo A, Calabro V, Velardi V, Fabris B, Bernardi S J Clin Med. 2024; 13(21).

PMID: 39518686 PMC: 11546735. DOI: 10.3390/jcm13216547.

Cerebral Venous Thrombosis during Thyrotoxicosis: Case Report and Literature Update.

Raho E, Antonioni A, Cotta Ramusino N, Jubea D, Gragnaniello D, Franceschetti P J Pers Med. 2023; 13(11).

PMID: 38003871 PMC: 10672691. DOI: 10.3390/jpm13111557.

Apathetic Thyroid Storm with Cardiorespiratory Failure, Pulmonary Embolism, and Coagulopathy in a Young Male with Graves' Disease and Myopathy.

Ali A, Mostafa W, Fernandez C, Ahmad H, Htwe N Case Rep Endocrinol. 2020; 2020:8896777.

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Li B, Hu J, Chen X Exp Ther Med. 2018; 15(6):5125-5132.

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Stroke in a Young Man Secondary to Paroxysmal Atrial Fibrillation and Thyrotoxicosis: A Case Report.

Bazan R, Fernandes T, da Silva Mazeto G, Marques M, Braga G, Luvizutto G Case Rep Neurol. 2017; 9(3):228-233.

PMID: 29279710 PMC: 5731184. DOI: 10.1159/000479730.

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