48例脑静脉窦血栓形成的诊治

目的 对脑静脉窦血栓形成（cerebral venous sinus thrombosis，CVST）的发病特点进行综合分析并评估其治疗效果。方法 回顾性分析北京天坛医院和青岛即墨市人民医院神经内科收治的脑静脉窦血栓患者的临床资料。结果 2006～2010年两院共收治确诊的脑静脉窦血栓患者48例，24例（50.0%）患者为亚急性起病，主要表现为高颅压综合征，8例（16.7%）患者伴肢体活动障碍或肢体抽搐，8例（16.7%）患者有意识障碍。颅脑磁共振静脉血管成像（magnetic resonance venography，MRV）均表现为不同程度的脑静脉窦闭塞。治疗以病因治疗、抗凝治疗、对症支持治疗为主，部分患者联合介入溶栓治疗。痊愈15例（占31.3%），好转30例（占62.5%），无效3例（占6.25%）。结论 CVST临床表现缺乏特异性，及时行颅脑磁共振检查是正确诊断和及时治疗的关键，抗凝治疗是CVST的主要治疗方法，治疗后该病预后相对良好。

Diagnosis and Treatment of 48 Cases of Cerebral Venous Sinus Thrombosis

Objective To analyze the features of cerebral venous sinus thrombosis （CVST）, and to assess the therapeutic effect. Methods To retrospectively analyze the clinical data of cerebral venous sinus thrombosis that comes from Beijing Tiantan Hospital and People＇s Hospital of Jimo. Results From 2006 to 2010, 48 cases of definite cerebral venous sinus thrombosis were treated in both hospitals, 24 （50.0%） cases were subacute onset, mainly for intracranial hypertension syndrome, 8 （16.7%） cases were complicated with limb movement disorder. Eight （16.7%） cases occurred disturbance of consciousness. The head magnetic resonance venography （MRV） showed different degrees of cerebral venous sinus occlusion. Etiological treatment, anticoagulant therapy, symptomatic and supportive treatment are the main measures. Thrombolytic therapy combined when necessary. Fifteen （31.3%） cases recovered, 30 （62.5%） cases improved, 3 （6.25%） cases invalid. Conclusion The lack of specific clinical manifestations of CVST, magnetic resonance imaging （MRI） should be the first line as soon as possible, the first MRI diagnosis and prompt treatment is critical, anticoagulant therapy is the first-line treatment for CVST. If received treatment, the disease has relative good prognosis.