脑静脉系统血栓形成123例临床表现和影像学特点

目的探讨颅内静脉窦血栓形成的临床表现和影像学特点。方法回顾性分析123例颅内静脉窦血栓形成患者的临床资料。结果123例患者中,男41例(33.3%),女82例(66.7%),中青年患者73例(59.35%);临床表现:头痛92例(74.8%),视物模糊30例(24.4%)。D-二聚体检查92例,68例(73.9%)升高;腰穿检查80例,颅内压增高66例(82.5%);头颅CT平扫示,静脉窦条状带高密度影13例(26%);头颅MRI平扫示,静脉窦流空信号消失及密度改变71例(71%);头颅磁共振血管成像示,106例(96.4%)血栓部位血流消失;数字减影血管造影13例,均可见血栓部位血流消失。经抗凝治疗后,痊愈62例(50.4%),好转57例(46.3%),死亡4例(3.3%)。结论脑静脉系统血栓中青年多发,以头痛为主要临床症状,头颅MRI及MRV检查有助于诊断,积极抗凝治疗有助于改善预后。

Clinical and imaging features of 1 2 3 patients with cerebral venous sinus thrombosis

Objective To explore the clinical and imaging features of cerebral venous sinus thrombosis(CVST).Methods Clinical data of 123 CVST patients were analyzed retrospectively.Results Forty-one patients(33.3%)were male and 82 patients (66.7%)were female.The first symptom was headache in 92 cases(74.8%),papilledema was found in 30 cases(23.4%).68 pa-tients with D-dimer increased in 92 patients with D-dimer examination.66 patients cerebrospinal fluid(CSF)pressure increased in 80 patients with lumber puncture CSF examination.Brain CT plain scan showed strap and cord sign in 13 cases.Brain MRI plain scan showed absence of a flow void and the presence of altered signal intensity in 7 1 cases.Magnetic resonance vengioaphy showed the disappearance of blood flow in the thromboembolic area in 106 cases.After anticoagulant therapy,recovered was in 62 cases, improved in 5 7 cases,and 4 cases died.Conclusion Clinical feature of CVST is that the incidence rate in high in middle-aged and young patients and headache is the chief manifestation.MRI combined with magnetic resonance vengioaphy have an important role in confirm the diagonosis of CVST.Anticoagulant therapy has good prognosis.