脑静脉窦血栓的早期诊治

目的探讨脑静脉窦血栓形成的早期诊断和治疗。方法对2005～2008年住院的12例脑静脉窦血栓形成病人的年龄、临床特征、实验室数据、影像学改变、治疗和预后进行回顾性分析。结果脑静脉窦血栓多为急性或亚急性起病，早期表现为非特异性头痛者9例，确诊前有5例误诊，脑脊液检查均有压力增高。8例病人行颅脑MRI及磁共振静脉血管显影（MRV）检查，诊断为脑静脉窦血栓形成者6例，阳性率75％。7例行数字减影血管显影（DSA）检查，均证实有脑静脉窦血栓形成。12例病人中7例行肝素抗凝治疗，2例痊愈，4例好转，1例死亡；5例行血管内介入治疗，4例痊愈，1例好转。结论脑静脉窦血栓形成临床表现缺乏特异性，对怀疑为脑静脉窦血栓形成的病人应及时行MRI＋MRV检查，必要时行DSA检查，一旦确诊应及时行抗凝及溶栓治疗，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。

EARLY DIAGNOSIS AND TREATMENT OF CEREBRAL VENOUS SINUS THROMBOSIS

Objective To explore the early diagnosis and treatment of cerebral venous sinus thrombosis （CVST）. Methods A retrospective analysis was done in 12 patients with CVST hospitalized in 2005-2008, the items analyzed included the patients＇ age, clinical manifestations, laboratory data, images, therapy and prognosis. Results The onset of CVST was mostly acute or sub acute, 9 patients manifested as nonspecific headache in the early stage, in which, five were misdiagnosed. Increase of CSF pressure was found in all patients. MRI and MRV were performed on eight patients, and CVST was confirmed in six patients （75%）. DSA was done in seven patients and all were confirmed as having CVST （100 %）. Anticoagulation therapy with heparin was given to seven patients with two recovered, four improved and one died. Interventionai treatment was given to five patients with four recovered and one improved. Conclusion The clinical manifestations of CVST are non specific, therefore, in patients with suspicious CVST, both MRI and MRV should be done in time, and DSA in case of need. When the diagnosis of CVST is confirmed, anticoagulation and thrombolysis therapy should he given at once. Interventlonal therapy might be the one of the most effective treatments for patients with CVST.