急性期脳梗塞例における内頸静脈血栓症の頻度と臨床的意義に関する検討

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Background and Purpose: Deep venous thrombosis (DVT) in the upper part of the body is rare, accounting for approximately 1 – 4% of all DVTs. The incidence and clinical significance of jugular vein thrombosis (JVT) were investigated in consecutive patients with acute ischemic stroke.Subjects and Methods: From December 2006 to March 2007, 71 patients (46 men, aged 70.8 ± 13.2 years) hospitalized within 48 hours after ischemic stroke or TIA onset were retrospectively examined. The presence of JVT was evaluated by ultrasonography. Patients with jugular vein catheterization were not included. Age, sex, hypertension, diabetes mellitus, hyperlipidemia, smoking status, presence of a malignant tumor, and D-dimer were assessed.Results: JVT was demonstrated in four patients (5.6%). The rate of a malignant tumor was significantly higher in patients with JVT than in those without (100% vs. 14.9%, p<0.001). The tumors were as follows: esophageal cancer (1); lung cancer (1); and uterine cervical cancer (2). The stroke subtype in three patients was Trousseau syndrome with a high D-dimer value, and that in the other patient was a lacunar stroke with a normal D-dimer value.Conclusions: Ultrasonographic evidence of JVT in patients with acute ischemic stroke could be a marker of a coincidental malignant tumor with or without Trousseau syndrome.
日本脳神経超音波学会の論文