横窦变异对大面积脑梗死患者出院时预后的影响

Impact of variations of the transverse sinuses on the prognosis of patients with massive cerebral infarction at hospital discharge

目的探讨横窦变异对大面积脑梗死患者临床预后的影响。方法对11例大脑中动脉主干或颈内动脉主干闭塞的脑梗死患者在脑水肿期进行MRV或DSA检查,根据检查结果分为横窦优势侧梗死组和横窦非优势侧梗死组,分析大面积脑梗死后颅内高压对颅内静脉和静脉窦的形态学影响,并比较两组患者在治疗前、后神经功能缺损的变化。结果 MRV检查示梗死侧静脉显影明显减少;大面积脑梗死后上矢状窦、横窦、乙状窦形态学未见改变;两组患者在治疗前、后NIHSS、MRS评分比较无统计学差异。结论横窦变异对大面积脑梗死患者的预后无明显影响。

Objective To explore the impact of variations of the transverse sinuses on the prognosis of patients with massive cerebral infarction. Methods Eleven patients with middle cerebral artery stem occlusion or internal carotid artery stem occlusion were examined with MRV or DSA in acute phase of cerebral edema. According to the examination results, these patients were divided into two groups： the ipsilateral transverse sinus dominant group and the ipsilateral transverse sinus hypoplastic group. The impact of intracranial hypertension following massive cerebral infarction on the morphology of cerebral veins and cerebral venous sinuses was analyzed, and neurological deficits of patients in these two groups before and after treatment were compared. Results Diminished visibility of vasculature was shown in ipsilateral cerebral veins. There were no morphological changes in superior sagittal sinus, transverse sinuses and sigmoid sinuses following massive cerebral infarction. No statistically significant differences were observed when comparing changes of NIHSS and MRS scores before and after treatment between the two groups. Conclusions Variations of the transverse sinuses do not affect the prognosis of patients with massive cerebral infarction at hospital discharge.