颅内静脉窦血栓形成的诊治(附9例报告)

Cerebral venous and sinus thrombosis

目的探讨颅内静脉窦血栓形成(CVST)临床表现、诊断及治疗。方法回顾性分析9例经影像学诊断为CVST的患者,行抗凝及血管内介入溶栓治疗。结果9例患者均有颅内压增高表现;3例癫痫发作;2例颅内出血;2例出现意识障碍;1例偏瘫。头部CT、MRI、MRV、DSA为诊断提供依据。8例应用低分子肝素治疗,1例进行血管内介入尿激酶溶栓治疗,同时进行肝素抗凝治疗。治疗后9例患者中7例症状完全缓解,2例症状明显好转。随访6例患者半年至2年,疗效稳定,无1例复发。结论CVST患者多有颅内压增高表现,及时行MRI、MRV及DSA检查,以明确诊断。抗凝治疗为首选治疗方法,血管内介入溶栓治疗协同抗凝治疗可提高疗效。

Objective To discuss the clinical presentation, diagnosis and therapies of cerebral venous and sinus thrombosis（CVST）. Methods We analysed 9 cases of CVST about their clinical presentation, diagnosis and therapies. Results 9 cases had intracranial hypertension ,3 cases had seisure,2 cases have intracranial hemorrhage ,2 cases had conscious disturbance, 1 case had hemiparalysis. These cases are diagnosed on the basis of CT, MRI, MRV and DSA. 8 cases had low molecular weight heparin therapy, 1 case has both heparin and interventional thrombolysis with urokinase. 7 cases had completely clinical relief,2 cases improved obviously. 6 cases are followed up for half to 2 years and none of them had a recidivation. Conclusions Most patients with CVST have an appearance of intracranial hypertension, and need promptly diagnosis on the basis of MRI, MRV and DSA. Anticoagulation therapy is the basic method and interventional thrombolysis therapy provides a new way.