脑静脉窦血栓形成的临床特点、危险及预后因素分析

[目的]探讨脑静脉窦血栓形成（CVST）的临床特点、诱因及影响预后的因素.[方法]回顾性分析2007年9月至2012年10月就诊于本院的40例CVST患者的临床表现、危险因素、影像学特点.所有患者均通过头磁共振平扫及静脉血管成像（MRI＋ MRV）或数字减影血管造影术（DSA）确诊.[结果]本组女26例（65％）,男14例（35％）,平均年龄（34±6.25）岁.头痛症状最为常见,占70％（28/40）.最常见的危险因素是口服避孕药和孕产妇,分别占30.0％（12/40）和27.5％（11/40）.上矢状窦和侧窦受累最常见,分别为65.0％（26/40）及55.0％（22/40）,病死率为15％（6/40）,发病时即出现意识障碍或颅内血肿与预后不良有关.[结论]CVST患者临床表现及体征多样,头痛为最常见临床表现,女性口服避孕药及妊娠生产为主要危险因素.该病病死率较高,尤其是发病后即出现意识障碍或伴有颅内血肿患者应给予足够重视.

Analysis of Clinical Features,Risk and Prognostic Factors of Cerebral Sinus Thromsis

[Objective]To explore the clinical features,incentive factors and prognostic factors of venous sinus thrombosis（CVST）.[Methods]Clinical manifestations,risk factors and image features of 40 patients with CVST in our hospital from Sept.2007 to Oct.2012 were analyzed retrospectively.All patients were confirmed by using cerebral magnetic resonance imaging and venous imaging（MRI±＋MRV） or digital subtraction angiography（DSA）.[Results] There were 26 females（65％） and 14 males（35％）,and the ratio of male to female ratio was 1/1.9.The mean age was 34±6.25 years old.Headache was seen in 70％ of the patients.The most frequent risk factors were oral contraceptive pills（OCP） and pregnancy/delivery（30.0 ％ and 27.5 ％,respectively）.Involvement of superior sagittal sinus and lateral sinus were commonly seen（65.0 ％ and 55.0 ％,respectively）.The fatality rate was 15 ％.Consciousness disorder or intracranial hematoma after onset was associated with poor prognosis.[Conclusion] Clinical manifestation and signs of patients with CVST are various.Headache is the most frequent symptom.OCP in women and pregnancy/delivery are the main risk factors.The fatality rate of the disease is higher,so patients with consciousness disorder or intracranial hematoma after onset should be paid more attention especially.