脑静脉窦血栓形成误诊原因分析

Misdiagnosis Analysis of Cerebral Venous Sinus Thrombosis

目的探讨脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的误诊原因,并提出减少误诊的对策。方法对我院2003年2月—2012年2月收治7例误诊的CVST的临床资料进行回顾性分析。结果本组7例因意识障碍、癫痫误诊为病毒性脑炎3例;因头痛、呕吐伴局灶性神经功能缺失误诊为脑梗死2例,脑出血1例;因胸闷、呕吐误诊为冠心病1例。误诊时间1～30 d。均经CT静脉造影(CTV)检查确诊,予脱水、抗凝、溶栓等治疗,6例好转,1例死亡。结论CVST早期临床表现无特异性,临床医生应提高对本病的认识,对疑诊患者及时行头颅CT及CTV等检查,可降低误诊率。

Objective To explore the misdiagnosis cause of cerebral venous sinus thrombosis（CVST） in order to reduce misdiagnosis.Methods Clinical data of 7 misdiagnosed patients with CVST during February 2003 and February 2012 were retrospectively analyzed.Results 3 patients out of the 7 patients with disturbance of consciousness and epilepsy were misdiagnosed as having virus encephalitis;3 patients with headaches and vomitting combined with focal nerves afunction were misdiagnosed as having cerebral infarct（2 patients） and cerebral hemorrhage（1 patient）;One patient with dyspnea and vomiting was misdiagnosed as having coronary artery disease.The duration of the misdiagnosis period was 1~30 days.The 7 patients were finally diagnosed by CTV and CT,and given dehydration,anticoagulation and thrombolytic therapies.6 patients improved and 1 patient died.Conclusion Clinicians should raise awareness of CVST of the early unconspicuous symptoms of CVST.The brain CT scanning and CTV features are valuable for diagnosing CVST and reducing misdiagnosis rate.