颅内静脉窦血栓形成22例临床分析

目的探讨颅内静脉窦血栓形成的临床特点。方法回顾性分析22例确诊的颅内静脉窦血栓形成患者的临床资料。结果 6例误诊(27.27%)。22～44岁、45～59岁及60岁以上病死率分别为7.14%、66.67%及80.00%,而显示年龄越大病死率越高,且误诊组病死率显著高于非误诊组(66.60%vs 18.75%,χ2=4.441,P=0.035<0.05)。头痛为首发及主要症状,非炎症病因为主,孕产妇多见。早期脑CT及脑MRI平扫可发现位于皮层脑叶的多发性病灶及静脉阻塞性脑肿胀。结论颅内静脉窦血栓形成临床表现复杂多样,易误诊,且年龄较大病死率可能越高。抗凝治疗是安全有效的。

Clinical analysis on 22 patients with cerebral venous sinus thrombosis

Objective To explore the clinical characteristic and treatment of cerebral venous sinus thrombosis(CVST).Methods A retrospective study on the clinical data of cerebral vein and sinus thrombosis in 22 patients was conducted.Results Six patients were misdiagnosed primarily,accounted 27.27% of the 22 patients.Of 22 cases,7 were of complete recovery,8 were improved,7 died,and the deterioration and fatality rate was 31.82%.In this study,the older the patients were,the higher ratio of death was(χ2=11.494,P=0.003<0.05).Additionally,there was higher ratio of death in the misdiagnosed group than the diagnosed group(χ2=4.441,P=0.035<0.05).Cerebral venous sinus thrombosis was mostly induced by non-inflammatory diseases,and headache was frequently the initial cardinal symptom.Magnetic resonance imaging of the venous sinuses and digital subtraction angiography could early find the multi-lesion at cerebral lobe and vein-thrombosis cerebral swelling.Conclusion Cerebral venous sinus thrombosis is a rare and special ischemic cerebrovascular disease with complicated clinical presentations and high mortality,which was easily misdiagnosed.Anticoagulant therapy is safe and effective for this disorder.