上矢状窦血栓的病因及诊断

Etiology and diagnosis of the superior sagittal sinus thrombosis

摘 要：目的 探讨上矢状窦血栓的病因及诊断方法。方法 分析34例上矢状窦血栓患者的病因、临床表现、影像学特征，其中3例无明确诱因所致上矢状窦血栓患者，利用化学分光法检测其血清中的雌二醇（E2）、累酮（T）水平。结果 上矢状窦血栓最常见的病因是产褥期血液高凝状态，3例未查到明确诱因的青年男性患者，血清中E2↑、E2↑、T↑。上矢状窦血栓的临床表现以头痛最常见，在意识清楚的30例患者中发生率为100％。影像学检查：CT检出率仅为65．4％，磁共振成像（MRI）、磁共振静脉血管造影（MRV）检出率为100％。结论 各种原因造成的血液凝固性增高是上矢状窦血栓最常见的病因，男性高雌激素血症是其发病的一个重要的危险因素。MRI和MRV技术相结合是诊断上矢状窦血栓的最佳方法。

Abstract: Objective To explore the etiology and diagnosis of the superior sagittal sinus thrombosis (SSST). Methods We analyzed the etiology .manifestation and image feature of 34 cases of SSST. For 3 cases of SSST without definite causes,we measure the value of the estuarial (E2) and testosterone (T). Results The most common reason of SSST was hypercoagulable state of perinatal period. 3 of cases of idiopathic made patients showed elevated E2 and E2/T value. Headache was the most common clinical manifestation (100% of the conscious patients). Only 65. 4% patients were positive in CT,while the positive rate of MRI and MRV were 100%. Conclusion The most common reason of SSST is hypercoagulable state. High level of estrus is a risk factor to male patients. The combination of MRI and MRV is the best method to diagnose the SSST.