[Diagnosis of Graves' disease by cerebral venous thrombosis: a case report]

Abstract

A 71-year-old male with no previous medical history was admitted to our hospital for paralysis of the right upper extremity. Although DWI of the brain revealed high-intensity signals in the bilateral frontal and left parietal lobes, CT revealed a hyperdense spot in the anterior superior sagittal sinus (SSS). Because CT venography revealed SSS occlusion, he was diagnosed with cerebral venous thrombosis (CVT). In addition, laboratory findings, including free triiodothyronine, 8.85 pg/ml; thyroxine, 3.39 pg/dl, thyroid-stimulating hormone (TSH), < 0.02 μU/ml; and anti-TSH receptor antibody, 5.7 IU/l, led to the diagnosis of hyperthyroidism for the first time. Moreover, factor VIII procoagulant protein levels exhibited a marked increase (187.5%). Based on these findings, the patient was diagnosed with CVT due to Graves' disease.

Keywords: Graves’ disease; cerebral venous thrombosis; factor VIII procoagulant protein; hyperthyroidism.