颅内静脉窦血栓形成的病例分析及文献复习

Case analysis and review of literature about cerebral venous sinus thrombosis

目的探讨颅内静脉窦血栓形成(CVST)的诊断及治疗措施。方法回顾性分析19例CVST患者的临床资料。结果19例患者中青年患者占78.9%。急性亚急性起病的占94.7%。临床表现以头痛多见,占73.8%。10例行腰穿检查,7例出现出现压力升高。头颅CTV、MRV及DSA均可发现受累静脉窦,以横窦、乙状窦受累多见,占89.4%,其次为上矢状窦血栓。治疗上主要采取综合治疗,抗凝治疗为最主要治疗。结论CVST临床表现多样,无特异性,早期诊断需借助头颅CTV、MRV及DSA,治疗上以抗凝治疗为主,应考虑联合介入治疗,早诊断、早治疗为关键。

Objective To investigate the diagnosis and treatment of cerebral venous sinus thrombosis（CVST） .Methods The clinical data of 19 patients with CVST were retrospectively analyzed .Results The CVST occurred in middleeaged and young patients （78.9% ） mainly .About 94.7% of the patients had subacute or acute onset .The clinical manifestation showed head ache in 14 cases（73.8% ） .10 patients were treated by lumber puncture CSF examination and 7 accompanied with high cerebro spinal fluid pressure .CTV/MRV/DSA showed abnormal cerebral venous sinus .The veins more involved were the transverse sinus and sigmoid sinus（89.4% ） ,followed by the upper sagittal sinus .Anticoagulation was the chief treatment .Conclusion The clinical manifestation of CVST is variable and nonspecific .CTV ,MRV and DSA will contribute to early diagnosis .Antico agulation is the chief treatment ,combined with interventional thrombolysis therapy when necessary .Early diagnosis and early treatment are important to the outcome .