Case-report of evidenced-based treatment of dural sinus thrombosis

MengQiang，DongManli，LinLan，ZhongJingmei，ZhaiMing，WuShaoyuan，ZhangJinzhang，DepartmetofNeurology，FirstPeople＇sHospi－talofYunnanProvince，Kunming６５００３２，YunnanProvince，ChinaINTRODUCTIONDuralsinusthrombosis（DST）isaseldomandspecialcerebrovas－culardiseaseinclinic，whichcancausesevereresultssuchasblindness，comaandevendeath．Nowthereisnounitarytreatmentplanforthisspecialcerebrovasculardisease．Onthebasisofre－trievingdomesticandabroaddocumentsaboutthisdisease，３pa…     

小儿外伤性颅内静脉窦损伤（附31例报告）

小儿外伤性颅内静脉窦损伤（附３１例报告）黄思庆易章超华西医科大学附属第一医院神经外科小儿外伤性颅内静脉窦损伤在颅脑外伤中发生率较低，约占同期全部颅脑损伤的１％。本病的预后与术前的判断和术中的处理关系密切，若术前判断得当、准备充分、处理正确，则预后良好...     

左横窦、乙状窦血栓形成1例报告

硬脑膜静脉窦血栓形成 (ＤＶＳＴ)为少见脑血管病 ,多有明确原因 ,临床表现多样而无特异性 ,容易误诊 ,病情严重 ,死亡率较高。提高对本病的认识 ,及早、及时、正确治疗对改善预后有重要意义。本科近来收治左横窦、乙状窦血栓形成１例 ,现综合文献报道如下。病例资料患者 ,女 ,４９岁 ,因头晕、头痛３天伴短暂意识丧失２次于１９９９年３月６日入院。患者于３天前晚餐饮少量白酒后感畏寒不适而上床休息 ,当夜１１时左右感头晕 ,额部、后枕部持续性胀痛 ,１小时后觉头晕加剧 ,双眼视物旋转 ,随即意识丧失 ,但无四肢抽搐及二便失禁。５分钟后…     

静脉窦血栓形成临床分析——附2例病例报告

颅内静脉窦血栓形成(CVST)是脑血管病的一种特殊类型，病因不同，部位不同，临床症状各异，导致临床诊断困难。随着影像技术的发展，对此疾病的认识逐渐增加，我科近期收治2例静脉窦血栓病人治疗效果满意，2例均为年轻女性，以头痛、恶心、呕吐为主要表现，经头颅CT及MRI检查诊断明确。此病为少见病，发病率不清，病因复杂，有患者仅表现为发热头痛，意识障碍，易误诊为脑炎，有的出现偏瘫、头痛、呛咳诊断为脑梗塞，因头痛恶心呕吐，视乳头水肿，误诊为良性颅内压增高等。本例1患者因CT可见小脑旁高密度影，误诊脑出血。后经头颅MRI检查诊断，诊断明确，肝素抗凝治疗后，头痛减轻至消失。随着神经影像的发展，DSA检测的普及，静脉窦血栓形成的诊断阳性率将逐渐增高，导管介入技术的开展，药物溶栓治疗，亦是CVST。治疗的新途径，值得进一步探讨。     

红细胞增多症并颅内静脉窦血栓1例报告

1临床资料 患者,男,48岁,因头痛、呕吐5d于2009年6月1日入景德镇市第一人民医院。患者5d前无明显诱因出现头痛,为持续性胀痛;伴恶心、呕吐,无肢体活动障碍、抽搐、发热、视力下降及复视。有慢性支气管炎病史10年,吸烟20多年,每天1包。     

颅内静脉窦和脑静脉血栓形成—关于“产后13天，头痛2天，抽搐、昏迷2小时”的病案讨论

1　本病例临床特点①患者为产褥期妇女 ,妊娠期间患“妊娠中毒症” ;②产后出现腹泻 ,继之头痛、呕吐 ,突然抽搐、昏迷 ;③抽搐过后无肢体瘫痪 ,双侧巴氏征 ( ) ,克氏征 (-) ;④双眼球病初向左侧凝视 ,几小时后又向右侧凝视 ;⑤先后出现颞叶钩回疝和枕骨大孔疝而死亡。2　应进一步作哪些辅助检查为明确诊断 ,入院后立即行颅脑ＣＴ扫描 ,结果发现右额叶皮层处见一最大截面约 2ｃｍ× 2ｃｍ大小的等高密度混合灶 ,ＣＴ值约 4 0～ 60Ｈｕ ,周围环一不规则低密度影 ,右顶叶皮层处有大片状楔形低密度影 ,右颞叶底部见一索条状 2ｃｍ长的高密度影 …     

产后颅内静脉窦血栓形成1例分析

对产后颅内静脉窦血栓形成1例分析如下。1病历摘要女,24岁。以间断抽搐8 d意识模糊8 h就诊。13 d前在家中自行产下一足月男婴,因合并会阴Ⅲ度裂伤,在当地医院清创缝合,5 d后拆线,回家当晚抽搐1次,其后头痛,呕吐,腹泻,按胃肠炎在当地治疗,因出现意识障碍行头颅CT示:左额叶低密度影,随转入我院。入院时嗜睡状,贫血貌,急性病容,双侧瞳孔不等大,左侧5 mm,右侧3 mm,光反射迟钝,颈抵抗,颌下二横指,无明显肢体活动障碍。血象示W BC 14.36×109/L,Hb 89g/L,低钾2.2 mm o l/L,低镁1.76 mm o l/L。入院考虑诊断:颅内多发静脉窦血栓形成,中度贫血,低钾血症,低镁血症。给予抗凝治疗,皮下注射低分子肝素钙4 000 U,2次/d,同时甘露醇,甘油果糖,激素降颅压,三代头孢抗感染。1 d后高热,病情恶化,急转直下,行头颅M R I及M RV检查示:上矢状窦及左侧乙状窦静脉血栓形成合并颅内出血性梗死。于当日脑疝形成,呼吸,心跳停止,立即气管插管,心肺复苏,人工呼吸,于次日抢救无效死亡。2讨论颅内静脉窦血栓形成(CVT)是妊娠及产褥期妇女最常见的卒中类型,90%发生在产褥期或...     

脑静脉窦血栓形成误诊1例分析并文献复习

目的:分析脑静脉窦血栓形成误诊原因及治疗方法。方法:应用核磁共振脑静脉造影(MRV)确定诊断,通过临床诊治过程,结合文献对脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的病理学特征、临床类型、误诊原因及治疗进行探讨。结果:CVST是一种特殊类型的脑血管疾病,病因复杂、起病形式多样,临床表现缺乏特异性,头部CT特异性和敏感性不高,脑脊液检查正常,易造成误诊及漏诊。结论:CVST发病急、进展快、死亡率较高,MRV是诊断脑静脉窦血栓形成并检测疗效的首选影像学检查方法,抗凝治疗是一种安全有效的方法。     

24例静脉窦血栓形成患者的临床特点分析

颅内静脉窦血栓形成（cerebral venous sinus thrombosis，CVST）是少见血管病，病因复杂，临床表现多样而无特异性，因此误诊率较高。本文搜集2006年2月至2012年3月治疗的24例CVST 病例资料，作一回顾性分析，旨在探讨CVST 的临床特征及治疗措施。     

Giant fibrovascular polyp of the esophagus—imaging techniques for proper treatment planning: report of two cases

Giant fibrovascular polyps of the esophagus are rare, benign mesenchymal intraluminal lesions that arise from the cervical esophagus and can reach a very large size. Surgical excision is the treatment of choice, since endoscopic removal alone is not always feasible due to the presence of a very much vascularized stalk in most cases. We present two archetypal cases emphasizing the fact that these lesions can grow to huge masses with various and bizarre clinical presentation and they can arise (although rarely) at the level of the hypopharynx. We also aim to point out the role of imaging in defining the exact origin and characteristics of the stalk (width, vascularization) and the polyp structure (tissue components), thus providing useful information for planning the most appropriate surgical approach.     

反复血管栓塞、截肢—抗磷脂综合征长期漏诊1例分析

对反复血管栓塞、截肢抗磷脂综合征长期漏诊1例分析如下。 1病历摘要 女,53岁。6a前查出双下肢深静脉血栓,5a前查出肺动脉栓塞,2a前因左上肢动脉血栓、坏疽,行截肢手术;病程中血小板进行性下降,最低达17×10^9／L;本次因气促伴右侧胸痛12d入院。既往曾有2次自然流产史;有血压升高史2a,最高达160／100mmHg,不规则服用替米沙坦治疗,血压控制欠佳。查体：BP160／100mmHg,左前臂中段以下缺如。     

First-trimester treatment of cesarean scar pregnancy using a cervical ripening—double-balloon catheter: A case report

Cesarean scar pregnancies are relatively rare. In the first trimester, if the decision is made to terminate the pregnancy, it should be done as soon as possible to avoid complications. We report a successful termination of a live, 6 weeks and 4 days cesarean scar pregnancy using a double-balloon cervical ripening catheter in a patient with two previous cesarean deliveries.     

产后颅内静脉窦血栓形成介入治疗1例报告并文献复习

目的：探讨产后颅内静脉窦血栓形成（CVST）的诊断与血管内碎栓治疗。方法：回顾总结产后CVST患者的诊疗资料,复习近期国内外相关文献。结果：对1例产后CVST患者进行血管内机械取栓及接触性溶栓治愈。随访3个月无复发。结论：产后CVST早期诊断极其重要,介入治疗可取得良好效果。     

Case based learning—a review of the literature: is there scope for this educational paradigm in prehospital education?

This paper discusses the findings of a literature review of case based learning (CBL) from a multidisciplinary health science education perspective and attempts to draw comparisons with the available literature relating to prehospital education and CBL.CBL is an exciting educational prospect in which to develop research capacity, strategies, and opportunities. This paper provides an examination of the literature exploring the major consistencies and inconsistencies, and reveals areas of potential future research for prehospital education institutions.     

Case report: Identification of recombinant HCV genotype 1b–2b by viral sequencing in two patients with treatment failure,who responded to re-treatment with sofosbuvir and daclatasvir

Hepatitis C virus (HCV) infection is a global health problem. HCV has been classified into seven genotypes and >67 subtypes. Genotyping is necessary to enable selection of appropriate treatments. The commercial molecular techniques currently used do not identify some HCV subtypes, mixed infections and recombinant forms. In this study, the core–E1 and NS5B regions were sequenced and phylogenetically analysed to identify infections by HCV recombinant genotype 1b–2b in two patients who had initially been diagnosed with HCV genotype 2 infection by reverse hybridization with a Versant HCV Genotype 2.0 Assay. Response to treatment was monitored by viral kinetics. Therapeutic failure occurred with initial treatment with PEGylated interferon-α2b and ribavirin, but the use of sofosbuvir and daclatasvir on a re-treatment regimen after reclassification of the infecting virus resulted in a sustained virologic response. The use of a sequencing approach in treatment-naïve infected patients could enable physicians to select the optimal therapy and avoid possible relapses and adverse reactions associated with antiviral therapy.     

STROBE Statement—Checklist of items that should be included in reports of case-control studies STROBE声明:病例对照研究报告写作清单①对文题、摘要、引言、方法的写作要求

Ⅰ.Title and abstract标题和摘要1(a)Indicate the study’s design with acommonly used term in the title or the abstract 用常用术语在标题和摘要和指出研究