脑静脉窦血栓形成12例临床分析

Cerebral venous sinus thrombosis 12 cases clinical analyses

目的总结脑静脉窦血栓形成的临床表现、影像学特征及治疗方法,减少误诊率及改善预后。方法对2004年至2008年住院的12例脑静脉窦血栓形成患者的临床表现,实验室资料,影像学特征,治疗经过及预后进行回顾性分析。结果12例中,10例临床表现为非特异性的头痛。确诊前有6例发生误诊,误诊率高达50%。10例患者行头颅磁共振成像及磁共振静脉血管显影检查,明确诊断为静脉窦血栓形成者8例,阳性率80%。5例行数字减影血管显影检查的患者,均证实有静脉窦血栓形成。所有患者均行降颅压及抗凝治疗,8例好转,2例无明显改变,2例死亡。结论脑静脉窦血栓形成临床表现缺乏特异性,误诊率高,确诊有赖于影像学检查,抗凝治疗仍为常规,安全且有效的方法。近年来血管内介入治疗具有不可替代的优越性。

Objective To summarize the cerebral venous sinus thrombosis clinical manifestations, imaging features and treatment to reduce the rate of misdiagnosis and improve the prognosis. Methods 2004 - 2008 of 12 cases of hospitalized cerebral venous sinus thrombosis in patients with clinical, laboratory, imaging features, treatment and prognosis after a retrospective analysis. Results The results of 12 cases, 10 cases of non-specific clinical manifestations of a headache. There are diagnosed before the misdiagnosis occurred in 6 cases, the misdiagnosis rate was as high as 50%. 10 cases of patients with brain magnetic resonance imaging and magnetic resonance imaging examination vein, a clear diagnosis of venous sinus thrombosis in 8 cases, the positive rate of 80%. 5 routine DSA imaging examination of patients, were found to have venous sinus thrombosis. All patients had lower line anticoagulation therapy and the intracranial pressure, 8 patients improved, no significant changes in 2 eases, 2 deaths. Conclusion Cerebral venous sinus thrombosis lack of specific clinical manifestations, the high rate of misdiagnosis, the diagnosis depends on imaging, conventional anticoagulation therapy is still safe and effective way. In recent years vessel intervention in the treatment of an irreplaceable advantages.