A case of intracranial hemorrhage following superior sagittal sinus thrombosis associated with nephrotic syndrome

A case of intracranial hemorrhage due to superior sagittal sinus thrombosis occurring in a boy with nephrotic syndrome is described. A twelve-year-old boy with nephrotic syndrome presented sudden onset of generalized convulsions. CT scan revealed a subcortical hematoma in the left frontal lobe. A left carotid angiography revealed the occlusion of the superior sagittal sinus. Neurological findings included disturbance of consciousness, right hemiparesis, and motor aphasia after the convulsions. All symptoms and signs disappeared immediately. There has been no evidence of rebleeding or convulsions for the last two years. This case had no abnormality of the coagulation system in routine investigation, but nephrotic syndrome and steroid therapy appeared to be associated with several disorders of the coagulation system. The authors suggested that it was necessary to pay attention to possible intracranial hemorrhage caused by cerebral venous sinus thrombosis in patients with nephrotic syndrome or who had undergone steroid therapy.