脑静脉窦血栓形成的诊断与血管内治疗

目的 探讨脑静脉窦血栓形成的诊断和血管内溶栓治疗。方法 对8例以顽固性头痛、呕吐伴或不伴局灶性神经功能缺损或癫发作为主要表现的患者，采用颅脑MRI和脑血管造影检查确定诊断，并施行经颈内动脉、静脉窦内接触性溶栓或静脉窦内支架成形术协同抗凝治疗。结果 MRI显示相应脑静脉窦区出现长T2WI，短T1WI信号，DSA显示脑静脉窦闭塞、静脉侧支循环建立和脑动静脉循环时间延长。治疗后静脉窦完全或部分再通，脑循环时间接近正常，临床病情显著缓解。结论 血管内介入治疗可能是脑静脉窦血栓形成最有效的治疗方法之一，有待大样本研究证实。

Diagnosis and Endovascular Treatment of Cerebral Venous Sinus Thrombosis

Objective To investigate the diagnosis and endovascular treatment of cerebral venous sinus thrombosis(CVT). Methods Eight patients with main symptoms which included intractable headache, vomiting, with or without focal neurological impairment and/or seizures were diagnosed with CVT by magnetic resonance imaging(MRI) and digital subtraction angiography(DSA). Combined with anticoagulation, thrombolysis was performed via carotid arteries and sinuses, and sometimes stent angioplasty was used. Results The long T2WI and short T1WI signal in regions of venous sinuses on MRI and occluded sinus, lateral circulation, and delayed cerebral arteriovenous circulation time on DSA were the important characteristics for the diagnosis of sinus thrombosis. After the treatment, angiography revealed recanalization completely or partly, circulation time appeared to be normal and clinical deficits were considerably improved. Conclusion Endovascular treatment for CVT may be one of most effective therapies and it needs large samples to confirm.