14例颅内静脉窦血栓形成临床特征分析

目的探讨颅内静脉窦血栓形成患者的临床特征。方法回顾性分析14例CVST患者的临床资料。结果本组患者男性2例,女性12例;年龄15-55岁,平均年龄32±5岁。12例有明确病因,多数以急性、亚急性起病。首发症状以头痛多见,临床表现以颅高压三主征及皮层功能损害的局灶症状体征为主。缓慢起病者确诊时间延长。疾病易误诊为单纯的脑出血、脑梗死等。影像学表现为静脉窦闭塞及以皮质为主的梗死或水肿,可伴出血。治疗以抗凝、脱水为主。4例治愈,5例好转,5例死亡。结论 CVST患者临床差异较大,缺乏特异性,需要综合分析避免漏诊和误诊,及早行MR I+MRV检查,及早抗凝。

Clinical characteristics analysis of fourteen cases with cerebral venous and sinus thrombosis

Objective To explore the clinical characteristics of cerebral venous and sinus thrombosis（CVST）.Methords The clinical data of 14 patients with CVST were retrospectively analysed between 2004 and 2010,including sex,age,risk factors,mode of onset,course,clinical manifestations,results of laboratory examinatons,radiographic findings,diagnosis,misdiagnosis,treatment and prognosis.Results Among the group,2 were male and 12 were female.The ages ranged from 15 to 55 years old,with 32±5 years on average.12 cases could be determined the causes of diease,and acute or subacute onset accounted mostly.The most frequent initial clinical manifestation was headache,the principal clinical symptoms were intracranial hypertension and focal neurological deficit.The diagnosis time of the chronic patients was extended.Many patients were misdiagnosed as cerebral hemorrahage,cerebral infarction and many other diseases.The imaging features were venous and sinus occlusion or edema,accompanied by hemorrahage.The treaments were mainly on anticoagulation and dehydration.Among the cases,4 cases recovered,5 cases improved and 5 cases were dead.Conclusion The clinical characteristics of CVST patients is various and nonspecific,so integrative analysis is necessary to avoid misdiagnosis and missed diagnosis.MRI＋MRV should be taken as soon as possible.Early anticoagulation treatment is effective.