脑静脉窦血栓形成16例临床分析

目的总结脑静脉窦血栓形成的临床表现及影像学特征，减少该病误诊率及死亡率。方法对2003年-2005年住院的16例脑静脉窦血栓形成患者的临床表现，实验室资料，影像学特征，治疗经过及预后进行回顾性分析。结果16例中，13例临床表现为非特异性的头痛。确诊前有10例发生误诊，误诊率高达62．5％。15例患者行头颅磁共振成像及磁共振静脉血管显影检查，明确诊断为静脉窦血栓形成者12例，阳性率80％。12例行数字减影血管显影检查的患者，均证实有静脉窦血栓形成。所有患者均行降颅压及抗凝治疗，9例好转，1例无明显改变，6例死亡。结论脑静脉窦血栓形成临床表现缺乏特异性，误诊率高，确诊有赖于影像学检查，抗凝治疗是一种安全且有效的方法。

Clinical analysis of 16 patients with cerebral venous sinus thrombosis

Purpose To summarize the clinical and imaging feature of cerebral venous sinus thrombosis, so that decreasing the misdiagnosis rate and mortality about this disease in practice. Methods A total of 16 patients hospitalized between 2003 to 2005 were enrolled. We analyzed retrospectively the clinical features, laboratory data, neuroimaging changes, treatment and prognosis of them. Results Thirteen out of all 16 patients were presented nonspecific headache. Ten patients have been misdiagnosed, the rate of misdiagnosis reached 62.5 %. Twelve out of 15 patients were made a definite diagnosis as cerebral venous sinus thrombosis after neuroimaging examination of brain magnetic resonance imaging combined with magnetic resonance venography, the positive rate was 80%. Twelve patients accepted digital subtraction angiography examination were all confirmed as cerebral venous sinus thrombosis. All the patients were accepted anticoagulation and intracranial pressure control. Nine cases improved, 1 had no change and 6 died among all those patients during hospitalization. Conclusions Cerebral venous sinus thrombosis has no specific clinical feature and a high rate of misdiagnosis. Neuroimaging examination acts as a key role on the final diagnosis. Anticoagulation is a safe and effective therapy.