脑静脉窦血栓形成临床分析并文献复习(共268例)

Clinical Analysis with cerebral venous sinus thrombosis and review of literature

目的探讨脑静脉窦血栓形成(CVST)的临床特征及其诊治策略。方法回顾性分析268例(我院23例、文献245例)CVST患者的发病年龄、发病形式、临床表现、影像学特征及预后情况。结果本组男112例,女156例,年龄12～72岁,平均31.35±10.15岁,多数为急性亚急性起病,临床表现为单纯高颅压型180例(67.16%);局灶性缺损/癫痫型占38例(14.18%);亚急性脑病型44例(16.42%);海绵窦血栓形成6例(2.24%)。影像学表现为静脉窦闭塞及局灶性梗死灶,部分伴发渗血或血肿。结论认识CVST的临床特征并及时行MRI及MRV联合检查是正确诊断和及早治疗的关键。

Objective To describe the clinical characteristics of cerebral venous sinus thrombosis （CVST） and explore its strategy of diagnosis and treatment. Methods Medical records, including age, mode of onset, clinical manifestations, findings of neuroimaging and prognosis were analyzed retrospectively in 268cases with CVST（23 cases were inpatients of our hospital,245 cases recorded in literature）. Results CVST occurred in the second and forth decades mainly,acute or subacute onset mostly. 180 cases （67. 16% ） had a clinical pattern of isolated intracranial hypertension,38 cases （14. 18% ） of focal deficits/seizures ,44 cases（ 16.42% ） of subacute encephalopathy and 6 cases（2.24% ） of cavernous sinus thrombosis. The neuroimaging findings of CVST were venous sinus occlusion and local infarction, sometimes accompanied with capillary hemorrhage or haematoma. Conclusion Improvement in awareness of CVST and prompt MRI in combination with MRV examination is the key point in accurate diagnosis and timely therapy.