-Several infectious etiologies are related to cerebral venous thrombosis (CVT), but a review of l i t e r a t u reshowed only few cases related to tuberculosis (TB), and only one with neurological manifestat i o n s . We re p o rt an unusual case of CVT related to TB and mutation in pro t h rombin gene. A 38-man black p resented abrupt right hemiparestesis, and hemiparesis. Investigations revealed CVT. Cerebral spinal flui d (CSF) examination evidenced a infection by Mycobacterium. He was heterozygous for G20210A pro t h ro mbin mutation. Pro b a b l y, hypercoagulability mechanisms of TB, added to mutation of pro t h rombim gene increase the risk of CVT.KEY WORDS: cerebral venous thrombosis, tuberculosis, prothrombin gene mutation.Tuberculose: uma causa rara de trombose venosa cerebral?RESUMO -As mais variadas etiologias infecciosas estão relacionadas a trombose venosa cerebral (TVC), mas revisando-se a literatura há apenas poucos relatos de casos que se devem à tuberculose (TB), sendo que em apenas um deles havia manifestações no sistema nervoso central.Relatamos um caso de TVC associado a TB e a mutação do gene da pro t rombina. Homem 38 anos, negro, apresentou hemiparestesia de instalação súbita à direita, evoluindo com hemiparesia homolateral. Durante a internação, foi coletado líquor que evidenciou infecção por micobactéria. A pesquisa de trombofilias mostrou positividade somente para mutação do gene da pro t rombina(G20210A). Provavelmente os mecanismos de hipercoagulabilidade intrínsecos à tuberculose somados à mutação do gene da protrombina, potencializam o risco de TVC. PALAVRAS-CHAVE: trombose venosa cerebral, tuberculose, mutação do gene da protrombina.Occlusion of the central veins and sinuses occurs owing to thrombus, thrombophlebitis, or tumors. C e rebral venous thrombosis (CVT) is less fre q u e n t than arterial thrombosis, but can produce sequel a e or may be fatal 1 . Predisposing factors include infections, pregnancy and puerperium, hypercoagulable states, acquired and congenital heart diseases, red blood cells disorders, malignances, connective tissue disorders, severe dehydration, liver disease, s u rg e ry, sex steroid administration, and major traum a s 1 . Many infectious causes are related to CVT, but a review of literature showed few cases re l a ted to tuberculosis (TB). Only one, with neuro l o g ical manifestations, could be associated to Mycobacterium tuberculosis found in sputum culture 2 . We re p o rt the case of a man with CVT and systemic TB.
CASEA 38 years old black man was admitted to Neurological Emergence Service, and signed informed consent. He re p o rted that he had suddenly presented a b ru p t right hemiparestesis, and hemiparesis. He became better with treatment after one month of hospitalization. On this period, it was also diagnosed pulmonary tuberculosis, by chronic cough, fever, weight loss and acidfast bacilli on smear of sputum and testicle tuberc u l os i s by a scrotal ultrasound that showed an inflammatory m a s s of testicle and epididymis, which ...