脑静脉窦血栓形成12例临床分析

目的探讨脑静脉窦血栓形成(CVST)的病因,早期临床特点、影像学特征及治疗方法。方法回顾性分析12例脑静脉窦血栓形成患者的病因,临床表现,实验室资料,影像学特征,治疗经过及预后。结果早期的主要表现是,头痛11例,头痛伴呕吐5例,伴视力减退5例。能查找到病因的7例(58.3%)。11例患者行头颅磁共振成像(MR I)及磁共振血管显影(MRA)检查,诊断为静脉窦血栓形成者10例,阳性率83%。2例行数字减影血管显影检查(DSA),均确诊为静脉窦血栓形成。所有患者均行抗凝治疗,部分患者脱水降颅压治疗,2例脑疝形成患者开颅手术治疗。其中9例好转,1例无变化,2例死亡,死亡率16.7%。结论脑静脉窦血栓形成病因复杂,临床表现缺乏特异性,确诊有赖于影像学检查。抗凝,降颅压治疗安全有效。

Clinical analysis of cerebral venous sinus thrombosis

Objective To investigate the etiology,early clinical presentations,imaging characteristics and treatment of cerebral venous sinus thrombosis(CVST).Methods Etiology,clinical presentation,laboratory data,imaging characteristics,treatment and prognosis in 12 patients with CVST were retrospectively analysed.Results Early clinal presentations was as follows: headache in 11 patients,headache and vomit in 5 patients,headache and hypopsia in 5 patients.Etiology was fond in 7 patients(58.3%).MRI and MRA were performed in 11 patients,CVST was diagnosed in 10 patients with a positive rate of 83%.DSA was done in 2 patients,which confirmed the diagnosis of CVST.All the patients were given anticoagulation treatment,9 patients were given dehydration to control intracranial pressure,2 patients with cerebral hernia formation underwent operative cerebral decompressions.Nine patients improved,1 patient had no change and 2 died during hospitalization with a mortality of 16.7%.Conclusion CVST has complex etiology and no specific clinical presentations,final diagnosis mainly relies on neuro-imaging examination. Anticoagulation and decompression is safe and effective therapy.