颅内静脉窦血栓形成导致中枢性视野缺损的临床特点(附3例报告)

Clinical features of central visual field defects caused by intracranial venous sinus thrombosis(report of 3 cases)

目的探讨颅内静脉窦血栓形成(CVST)导致的中枢性视野缺损的临床特点。方法回顾性分析3例CVST导致中枢性视野缺损患者的临床资料。结果 3例患者均为急性或亚急性起病,均表现为视野缺损和视力下降,2例伴有头痛。发病早期眼底、眼压均正常,腰穿CSF压力轻度升高2例、正常1例。2例经MR静脉成像、1例行全脑血管造影检查示CVST。经抗凝治疗显著进步2例,进步1例。结论 CVST导致的中枢性视野缺损,往往出现于视盘水肿和明显的颅内高压症之前。提示中枢性视野缺损是CVST早期的重要表现。

Objective To approach the clinical features of central visual field defects caused by intracranial venous sinus thrombosis （CVST）. Methods The clinical data of 3 patients with central visual field defects caused by CVST were analyzed retrospectively. Results The onsets of the 3 cases were acute or subacute. The commom symptoms were impaired vision and visual field defects, and 2 patients accompanied with headache. In the early stage of the diseases, the fundus examinations and intraocular tensions were normal. CSF pressure of 2 cases increased moderately, and which of 1 case was normal. Two patients were diagnosed as CVST by MR venographic, and 1 patient was diagnosed as CVST by digital subtraction angiography. After anticoagulant therapies, 2 cases had significant progresses, and 1 cases had progress. Conclusions The central visual field defect caused by CVST often appears earlier than papilla edema and intracranial hypertension. Which indicates that the central visual field defect is an early important manifestation of CVST.