26例脑静脉窦血栓形成临床分析

目的分析脑静脉窦血栓形成(CVST)的病因、临床特点,提高对脑静脉窦血栓形成的诊断和治疗水平。方法回顾性分析2008-01-2016-01我院经头CT、MRV及脑血管造影(DSA)确诊的26例CVST患者,分析其病因、临床症状、腰椎穿刺结果、影像学特点及预后。结果病因有产褥期、妊娠期、长期服避孕药、重度脱水、肺癌、血液病、肥胖、自身免疫性疾病,另有病因不明者。首发症状表现为头痛、视乳头水肿、恶心呕吐、意识障碍、癫痫、偏瘫、发热及复视、视力下降。脑脊液检查示颅压增高、蛋白轻度增高,头CT示弥漫性脑水肿、蛛网膜下腔出血、空三角症、静脉性梗死致出血及未见异常。结论 CVST的临床症状多样化,确诊需影像学检查,积极治疗预后好,以综合治疗为主,包括脱水降颅压、降纤、抗凝及原发病的治疗和血管介入治疗。

Clinical analysis of 26 cases of cerebral venous sinus thrombosis

Objective To analyze the etiology and clinical features of cerebral venous sinus thrombosis (CVST) to further improve the diagnosis and treatment of cerebral venous sinus thrombosis.Methods In this study,we selected 26 cases of CVST patients diagnosed by CT,MRV and cerebral angiography (DSA) in our hospital from January 2008 to January 2016,and summarized the etiology and clinical symptoms,lumbar puncture results and imaging characteristics and prognosis.Results Puerperium,pregnancy,long-term contraceptive,severe dehydration,lung cancer,blood disease,obesity,autoimmune diseases and etiology unknown were the cause of CVST.Headache,papilledema,nausea and vomiting,disturbance of consciousness,epilepsy,hemiplegia,fever,diplopia and decreased visual acuity were the clinical symptoms of CVST.The cerebrospinal fluid examination of CVST showed intracranial pressure and mild protein increased.The imaging characteristics of CVST were diffuse brain edema,subarachnoid hemorrhage,empty triangular disease,venous infarction and no abnormalities.Conclusion CVST clinical symptoms with a variety of characteristics,the diagnosis required imaging examination and positive treatment result in good prognosis.CVST treatments are mainly comprehensive treatment including dehydration down the intracranial pressure,defibrillation,anticoagulation and the treatment of primary disease and intravascular interventional therapy.