The clinic met a patient with a headache, thanks to a check-up on him.

Headache in outpatients is very common, the cause of complex, can be light and heavy, but the next case, let me have a deeper understanding of headachepatients are middle-aged men, to "headache 3 days, aggravation of half a day" as the main complaint to outpatient visitscurrent medical history:3 days ago patients without obvious causeof head pain, the performance of persistent swelling pain, unbearable, accompanied by dizziness, for non-rotational, with nausea and body changes, accompanied by nausea and vomiting, vomit for the stomach contents, no limb weakness, no fever, cough, cough, no abdominal pain, diarrhea and other accompanying symptoms, untreated, and then the symptoms of the hospitalhistory, personal history, family history is nothing specialcheck body:, mental lysy, clear words, two-sided pupils and other large circles, diameter 3.5mm, eyeballs to all parties movement can, no eye shock, limb limb muscle strength, muscletensionnormal, two-sided Babinski signs (-), the remaining nervous system detection body did not see obvious abnormalitiessee patients with such severe headaches, and nausea, vomiting symptoms, is it caused by increased intracranial pressure? So give a perfect skull CT to see if there is any abnormality in brain tissueHead CT results back:is bleeding?" If it is bleeding, the amount of bleeding is so small, can not explain the patient's severe headache and nausea, vomiting and head swelling and other symptoms of high-pressure cranial, then what is the matter?so, in order to understand whether there is a cranial high pressure, lumbar puncture, measure dating pressure 400cm H2O, so high intracranial pressure, scared me quickly pulled out the puncture needle, in case the brain palate is in troubleBlood Test: Blood Clotting Function: Coagulation Enoriginal Time: 11.6s, INR value: 0.86, D-dipolymer: 2718 ng/mlBlood routine: white blood cells: 15.36 x 10 x 9/L, absolute value of neutrophils: 14.03 x 10 x 9/L, lymphocyte absolute value:1.06 x 10 x 9/Lthen analyze what causes cranial high pressure? A cranial magnetic resonance was then performed to see if there were other abnormalities in the brain that could not be shown on the skull CTcan see the high density shadow shown on the CT, does not show an abnormality on the magnetic resonance, but other anomalies (red circles) are found, what do you feel? Normalblood vesselsperipheral clearance?veinsblood clots? Or something else?combined with the patient's condition, headache! Headache! Severe headache! Important things to say a few times, and rule out cobweb subcavity bleeding, as well as cranial hypertension, is it the legend of intracranial sinus thrombosis? It looks very much like thatthen, to the application of cerebrovascular sharp: cerebrovascular imaging (DSA), the results are not expected, the imaging found on the back of the sinus, sinus and right cross-sinus, the sinus see a large number of blood clotsSo the sinus stent stent, with a little bit of blood clots were removed, the recovery of the vein blood flow, the patient said the head is not so painful, it seems that the effect is still very significant, and then given a tube, continued pumping into the urine kinasetreatment in the next few days, the patient's headache symptoms basically disappeared, review the contrast, see the sinus thrombosis basically eliminatedfinally, to put it simplyIntracranial venous sinus thrombosis is relatively rare, accounting for 0.5-1 percent of allstroke, acute mortality rate of 3-15 percent, common diseases due to protein C, protein S, anticoagulase 3 deficiency, pregnancy, fertility, hyperidenticalcysteine, nephropathy syndrome,infection, autoimmune immune disease, oral contraceptives, tumors, etc in the case of the patient, combined with the patient's past history, personal history, family history and auxiliary examination (blood is in a high-coagulation state, white blood cells and neutrophils have a high absolute value), considering the possibility of infectious diseases Mr Source: The Voice of Medicine