围生期颅内静脉窦血栓形成一例报道并文献复习

颅内静脉窦血栓形成(CVST)是一种特殊类型的脑血管病,各年龄段均可发病,在口服避孕药、围生期妇女中更为多见,其临床表现多样,病情发展迅速,若未及时诊治会引起严重的神经系统损伤,甚至死亡.本文介绍了1例就诊于陕西省人民医院神经内二科的围生期CVST患者的资料,回顾了2010—2021年围生期CVST相关文献,并总结了其...     

阵发性睡眠性血红蛋白尿合并脑静脉窦血栓形成1例并文献复习

阵发性睡眠性血红蛋白尿（paroxysmalnocturnalhemoglobinuria,PNH）是一种后天获得性造血干细胞克隆缺陷性疾病,可表现为溶血性贫血、血红蛋白尿和静脉血栓形成。脑静脉窦血栓形成（cerebral venous sinus thrombosis, CVST ）是PNH的一种少见但较严重的并发症。文章报道1例PNH合并CVST患者,并对相关文献进行了复习。对于伴有CVST 危险因素且表现为头痛、颅内压升高等神经系统症状的患者,应及早行颅脑影像学检查明确诊断,积极给予抗凝、脱水、祛除病因、控制并发症等方面的治疗。     

合并脑静脉窦血栓形成的Evans综合征一例并文献复习

作者回顾性分析1例合并脑静脉窦血栓形成(CVST)的Evans综合征患者的临床资料。患者中年女性,因突发头痛、呕吐入诊首都医科大学宣武医院神经内科,既往Evans综合征病史9个月。患者入院即存在溶血和血小板减少,MR静脉血管成像和DSA示上矢状窦、直窦及右侧乙状窦静脉血栓形成。脑脊液压力增高,眼底示双侧视乳头水肿,确诊为Evans综合征合并CVST。给予抗凝、激素及降颅压等治疗,症状好转。Evans综合征是自身免疫性溶血性贫血和免疫性血小板减少症并发的综合征,可增加发生血栓的风险。当患者出现头痛、呕吐及视乳头水肿等症状时,需警惕合并CVST的可能。Evans综合征合并CVST的患者,需长期抗凝治疗,同时在激素治疗的减量过程中,应警惕Evans综合征的复发。     

儿童轻度头部外伤致颅内静脉窦血栓形成一例并文献复习

儿童颅内静脉窦血栓形成(CVST)是一种罕见的脑血管疾病,其临床表现多样,很少由轻度头部外伤引起,临床中往往存在延迟诊断.作者报道1例轻度头部外伤引起儿童CVST的病例,并从PubMed数据库中检索到9例轻度头部外伤致CVST患儿的临床资料并进行回顾性分析,共对10例患者(包括本例)的临床特点、影像学表现、治疗及转归情...     

AngioJet流变溶栓抽栓术治疗颅内静脉窦血栓形成三例效果分析并文献复习

目的 探讨AngioJet流变溶栓抽栓术在治疗颅内静脉窦血栓形成(CVST)的安全性及可行性.方法 连续纳入2019年12月至2020年6月福建省漳州市医院脑血管病介入科接受Angiojet流变溶栓抽栓术治疗的3例CVST患者的临床和影像学资料并进行回顾性分析,并结合AngioJet流变溶栓抽栓术治疗CVST的相关文献...     

脑静脉窦血栓形成的动物模型

脑静脉窦血栓形成(cerebral venous and sinus thrombosis,CVST)是一种少见的缺血性脑血管病,60%的患者病变累及多个静脉窦,其中以上矢状窦血栓形成最为常见.CVST的发病机制及病理生理学迄今尚未完全阐明,建立稳定和理想的动物模型能为研究其发展、预后和疗效评估提供基础.文章对现有几种CVST模型的特点和优势进行了总结,但各种方法均有自身局限性.因此,建立更理想的动物模型有助于全面了解CVST的发病机制和病理过程.     

颅内静脉及静脉窦血栓形成的临床治疗进展

颅内静脉及静脉窦血栓形成（cerebral venous and sinus thrombosis,CVST）是由多种病因所致的以脑静脉回流受阻、脑脊液吸收障碍为特征的一种特殊类型的脑血管病,大约占全部卒中患者的0.5%～1%,在各年龄段均可发病,好发于20～35岁的年轻女性,男女发病比例为1.5∶5。     

幼儿硬脑膜动静脉瘘一例并文献复习

儿童硬脑膜动静脉瘘(DAVF)非常罕见,但进展迅速且预后极差,治疗具有挑战性.作者报道1例幼儿右侧侧窦区DAVF,患儿经动脉入路一次治愈性栓塞,术后恢复良好,术后3个月随访未见复发.作者同时回顾了相关文献,总结诊断和治疗经验.     

硬脑膜动静脉瘘误诊一例并文献复习

硬脑膜动静脉瘘(DAVF)是一种少见而复杂的疾病,患者病情进展迅速,可出现严重神经功能障碍,甚至危及生命.作者报道了1例以头痛起病,被2次误诊的青年女性DAVF,以"硬脑膜动静脉瘘"和"dural arteriovenous fistula"为关键词对万方数据库、中国知网、PubMed及Web of Science数据...     

Cerebral sinus thrombosis in a patient with hereditary protein S deficiency: Case report and review of the literature

Summary Hereditary protein S deficiency is an established risk factor for venous thrombosis. The common sites of thrombosis are the deep leg and pelvic veins. We report on a 38-year-old female patient with hereditary protein S deficiency and a previous history of deep leg vein thrombosis, who developed thrombosis of the cerebral straight and superior sagittal sinus while taking oral contraceptives. The diagnosis was established by computerized tomography and carotid angiography. Lysis of the thrombus occurred during heparin treatment. The hereditary nature of protein S deficiency was documented by family studies, since nine additional family members deficient in protein S were identified. Nineteen published cases of cerebral vein thrombosis and a deficiency of either antithrombin III, protein C, or protein S were reviewed. Compared with patients without a deficiency state, the clinical features of cerebral vein thrombosis were similar except for an earlier onset and a positive medical history of venous thromboembolic events in a considerable number of patients.     

经未显影静脉窦栓塞治疗硬脑膜动静脉瘘

目的探讨经未显影静脉窦栓塞治疗硬脑膜动静脉瘘（DAVF）的可行性、安全性及有效性。方法回顾性分析92例经未显影静脉窦栓塞治疗的DAVF患者的临床资料，其中病变位于海绵窦区91例，侧窦区1例。经颈内静脉的起始段探查未显影岩下窦，进入引流静脉窦内栓塞海绵窦区DAVF；通过颈内静脉探查未显影乙状窦，进入静脉窦栓塞侧窦区DAVF。首选可控纤毛弹簧圈进行栓塞，待血流减慢以后，用游离纤毛弹簧圈继续栓塞。若仍存在少量瘘口，通过静脉窦内注射液体栓塞剂（25％～33％Glubran或Onyx18），观察置管的成功率、安全性和栓塞的疗效。术后6个月通过电话、门诊或DSA随访。结果92例患者中，均未出现并发症，无死亡病例。1例海绵窦区DAVF患者置管失败；其余91例患者均顺利置管，并成功进行静脉栓塞。所有患者栓塞后即刻造影，均未见异常静脉窦早显，瘘口消失，达到了影像学上治愈。置管成功率及治愈率均为99％（91／92）。术后6个月对38例进行随访，无一例DAVF复发。对其余患者进行电话或门诊随访。所有患者临床症状好转或消失。结论经未显影静脉窦栓塞治疗DAVF，尤其对于海绵窦区DAVF，经未显影岩下窦超选择置管进行栓塞，具有较高的可行性、安全性及有效性，可作为海绵窦区DAVF的首选常规治疗方法。     

复合手术室内治疗伴静脉曲张的软脑膜动静脉瘘一例并文献复习

颅内软脑膜动静脉瘘为一种十分罕见的脑血管畸形,其由供血动脉、瘘口、引流静脉构成,且动静脉之间无畸形血管团。但由于引流静脉内的高流量特点,汇入引流静脉的正常静脉回流受阻,可导致静脉曲张现象,从而易误诊为颅内动静脉畸形。对软脑膜动静脉瘘保守治疗的病死率较高,建议行外科及血管内治疗,且仅需要消除瘘口,阻断动静脉间血流沟通即可。作者通过报道1例由大脑前动脉供血的软脑膜动静脉瘘的治疗体会,结合国外文献报道,探讨软脑膜动静脉瘘的定义、诊断及治疗。     

A sickle cell disease patient with dural venous sinus thrombosis: a case report and literature review

Abstract

Dural venous sinus thrombosis (DVST) is a rare disease associated with hypercoagulable states. Patients with sickle cell disease are known to be prothrombotic. We report a case of DVST presenting with anterior neck and facial pain in a 24-year-old female with sickle cell disease, found to have extensive thrombotic disease involving the internal jugular vein. A literature review of DVST in sickle cell disease consisting of 14 case reports was summarized. Headache was a presenting feature in two-thirds of patients. Nine cases were associated with vaso-occlusive crisis (VOC), transfusion, or acute respiratory illness. Most patients were treated with anticoagulation therapy. Over three-quarters either died or suffered from a serious neurological complication, including stroke, seizure, coma, or elevated intracranial pressure. Given its association with life-threatening complications, DVST should be considered when patients with sickle cell disease present with a VOC, especially in the context of headache or neurological deficits.     

天幕区硬脑膜动静脉瘘1例报告并文献复习

颅内血管畸形是一类临床表现复杂的疾病,其中10%~15%为硬脑膜动静脉瘘(dural arteriovenous fistula,DAVF)。硬脑膜动静脉瘘有一条或者多条供血动脉,这些供血动脉可以是硬脑膜动脉,也可以是脑动脉的脑膜支,引流静脉为静脉窦、软脑膜静脉或者脊髓静脉。供血动脉穿     

脑静脉窦血栓形成转归的预测因素——26例回顾性病例系列研究

目的 探讨脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)远期转归的预测因素.方法 回顾性分析26例CVST患者的临床资料,在发病后6个月应用改良Rankin量表(modified Ramkin Scale,mRS)评分评价临床转归.单变量和多变量分析确定远期转归不良的独立...     

肾病综合征合并脑静脉窦血栓患者的临床特点及预后

目的探讨肾病综合征（NS）并发脑静脉窦血栓（CVST）患者的临床特征及预后。方法回顾性分析2007年1月—2011年1月,南京军区南京总医院神经内科及肾脏病科住院的14例NS并发CVST患者的临床资料,对患者的临床表现、影像学、实验室检查、治疗及随访结果进行分析。结果①患者年龄为13～62岁,平均为（31±16）岁。主要临床表现为头痛、呕吐、运动功能障碍、癫痫发作。②CT/MRI/MRV提示CVST阳性比为13/14,1例患者在MR不能确诊的情况下,行DSA检查确诊。病变部位主要为上矢状窦,其次为横窦。③有12例患者的血清白蛋白〈25g/L,8例血浆纤维蛋白原〉4 g/L,8例D-二聚体〉500mg/L。经抗凝治疗后,FIB和D-二聚体降低,与治疗前比较,差异有统计学意义（P〈0.05）。④对14例患者随访12～60个月,平均（29±14）个月。对8例患者复查头部MRI/MRV,有6例显示闭塞的静脉或静脉窦再通。临床痊愈13例,改良Rankin评分（mRS）均为0分;遗留头痛的患者1例,mRS为1分。无一例CVST复发。结论 NS患者若出现头痛、运动功能障碍、癫痫发作,应及时行影像学检查明确是否为CVST。对于并发CVST,早期诊断及抗凝治疗,预后良好。     

脑静脉窦血栓形成患者颅内出血的预测因素

目的:探讨脑静脉窦血栓形成（cerebral venous sinus thrombosis, CVST）颅内出血的预测因素。方法:回顾性纳入2008年1月至2021年3月期间南京大学医学院附属鼓楼医院收治的CVST患者。收集危险因素、临床表现、影像学检查及发病后90 d随访资料,对并发颅内出血组和非出血组进行比较。应...     

Successful endovascular therapy for an adolescent patient with cerebral venous sinus thrombosis: A case report

Rationale:Cerebral venous sinus thrombosis associated with protein S deficiency is rare in adolescent patients and has high disability and fatality.Patient concerns: A 15-year-old male student presented in the hospital with sudden headache, nausea, and vomiting and was diagnosed with protein S deficiency by gene testing.Diagnoses:Cerebral venous sinus thrombosis due to protein S deficiency was diagnosed in this adolescent patient, who underwent successful endovascular therapy (EVT).Interventions:The patient was treated with standard anti-coagulation therapy including low-molecular-weight heparin (90 IU/kg/Q12 h) and dehydrant (mannitol 125 mL Q8 h); however, the symptoms were not alleviated. Successful EVT was implemented.Outcomes:Both the superior sagittal sinus and bilateral transverse sinus were recanalized after thrombus clearance. The patient achieved a complete recovery without any other stroke recurrence during follow-up.Lessons:EVT can be performed with favorable and effective clinical outcomes in adolescent cerebral venous sinus thrombosis patients with protein S deficiency. EVT associated with standard anti-coagulation therapy may improve the prognosis and reduce mortality among such patients.