脑静脉窦血栓形成15例分析

目的 探讨和研究脑静脉窦血栓形成(CVT)的早期诊断和治疗方法。方法 回顾性分析,15例CVT病人的临床资料,就其临床表现、影像学特征、脑脊液检查、治疗与预后,结合文献进行分析。结果 (1)年龄在19～52岁;(2)急性或亚急性起病;(3)早期表现为头痛(87％)、呕吐(60％)、视力障碍(33％),伴或不伴局灶性神经功能缺损;(4)影像学表现为静脉窦闭塞及局限性脑梗死(67％),其中20％伴有出血;(5)颅压明显升高,脑脊液白细胞及蛋白定量正常或升高;(6)病因治疗及脱水、抗凝、溶栓等治疗效果好。结论 对临床以颅内压增高为主要表现、伴或不伴有脑局灶性症状、体征的年轻病人,应考虑到CVT,及时行MRI或MRA检查,早期明确诊断,尽早治疗,抗凝治疗为其首选方法。

Clinical analysis of 15 cases with cerebral venous sinus thrombosis

Objective To research early diagnosis and treatment of cerebral venous sinus thrombosis (CVT) .Methods Medical records of 15 CVT patients, including clinical presentations, findings of neuroimaging and cerebral spinal fluid (CSF) , as well as the therapy are discussed in comparision with the literatures.Results CVT was most commonly seen in people of 19 - 52 years old, and the onset was most acute or suba-cute.The first symptomps included headache (87%), vomit (60%), defects of vision (33%), with or without focal deficits.Neuroimaging fing-ings showed 67% cerebral venous sinus occlusions and parenehymal focal infarction (with 20% hemorrhage or hematoma) .As for CSF examination, pressure increased remarkably, with WBC and protein normal or increased. Dehydration, anticoagulation, thrombolysis and etiologic treatment were utilized in the patients of CVT, the results were satisfied. Conclusion Headache, vomit with or without focal deficits as early presentation in young peoples should raise the suspicion of CVT. Neuroimaging examination make diagnosis for certain. Early administration of anticoagution is recommended as first - line treatment of CVT.