首诊于眼科的颅内静脉窦血栓形成的临床分析

Clinical features of vision decrease due to cranial venous sinus thrombosis

目的:探讨颅内静脉窦血栓形成的病因,相关眼科的临床表现、误诊情况及治疗方法。方法:前瞻性研究解放军总医院神经外科住院期间(2007-01),1mo中因首诊于眼科而误诊的4例CVST病例的临床表现、辅助检查、治疗及预后。结果:此病多以视力下降、头痛、恶心、视乳头水肿而首诊于眼科,此4例患者均有视力下降的症状,全部有视乳头水肿及颅压高等临床表现。阻塞部位均为横窦。结论:本病并不少见,早期容易漏诊误治,对于CVST患者,视力下降、视乳头水肿是其常见表现,可以通过DSA(经数字减影血管造影)做出早期诊断,对于颅内高压的症状应高度怀疑CVST。

AIM： To explore the cause, ocular manifestation of cranial venous sinus thrombosis （CVST）, and the misdiagnosis circumstance and therapy. METHODS： Four CVST patients who had been diagnosed by digital subtraction angiography （DSA） or magnetic resoance angiography （MRA） in January 2007 were studied, and their clinical manifestations, accessory examinations, treatment and prognosis are examined. RESULTS： All the 4 cases had visual decrease, and their symptoms varied by the position of thrombosis, including vision decrease, high intracranial pressure and optic disc edema. CONCULSION： CVST is often diagnosed wrongly or misdiagnosed, and the patients might visit; oculists first, Special attention should be paied to patients with intracranial hypertension with unknown cliagnosis.