脑静脉窦血栓形成的临床、影像学特点及病因分析

Characteristics of clinic and imaging and pathogeny analysis of cerebral venous sinus thrombosis

目的探讨脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的临床、影像学特点及发病原因。方法对22例CVST患者的临床及头颅影像学资料进行回顾性分析。结果 22例CVST患者中男5例,女17例,发病年龄21～71岁,急性起病13例,亚急性起病9例,首发症状以头痛多见,其次为发热、意识障碍、肢体无力、抽搐及视力障碍,其中2例并发下肢静脉血栓形成。22例中DSA检查1例、头颅MRV检查21例,累及2个以上静脉窦者12例,以上失状窦受累最常见,发病原因以分娩最常见,其他因有口服避孕药、炎症、外伤、贫血等,22例中基本痊愈21例。结论 CVST以女性多见,首发症状以头痛多见,发病原因以分娩常见,可伴发躯体静脉血栓形成,多累及2个以上静脉窦,MRV有助于早期诊断,早期治疗预后较好。

Objective To study the clinical and imaging characteristics of cerebral venous sinus thrombosis （CVST）.Methods To analyze the date of clinical and neuroimaging of 22 patients with CVST.Results There were 5 males and 17 females among the 22 patients.The age of onset ranged from 21 to 71 years old.13 cases had acute course,9 cases had subacute course.The symptoms which presented firstly included headache,fever,consciousness impairment,limb weakness,seizures,and weak sight.Among them,headache was the most frequent symptom.Two of these patients also suffered limb thrombosis.Among these patients,one case was performed DSA and 21 cases were performed MRV.There were 12 patients with at least two sinus affected.The superior saggital sinus thrombosis was the most common.The most common cause is childbirth,the other causes included oral contraceptive,inflammation,trauma and anemia.21 of the 22 patients had gained recovery completely.Conclusion CVST occurred more in female.Headache is the most common symptom which occured first,the most common cause is childbirth.Two sinus usually are affected in one patient.Limb thrombosis can occure with CVST.Early diagnosis and treatment are benefit for the prognosis.