颅内静脉窦血栓形成的临床特点及影像学分析

The analysis clinical and imaging characteristics for cerebral venous sinus thrombosis

目的探讨颅内静脉窦血栓形成(CVST)的临床特点与影像学特征,以提高临床医师对颅内静脉窦血栓的早期诊断率,降低误诊与死亡率。方法分析2009年5月至2011年1月本院收治的48例CVST患者临床资料,对其临床表现与影像学特征进行归纳。结果 CVST患者临床表现多样,以头痛为首发症状。其确诊主要依靠CT、MRI、MRV及DSA等影像学进行分析。经抗凝、降低颅内压等对症治疗,患者治疗后的颅内压有明显降低。48例患者中,治愈者26例(54.17%),好转者14例(29.17%),无效8例(16.66%)。结论颅内静脉窦血栓形成的病因多种,发病形式多样,且临床表现无特异性。头痛、呕吐、伴或不伴局灶性神经功能缺损为最常见的临床特征。结合CT、MRI及MRV可对其进行诊断,必要时可行DSA检查。早期使用抗栓治疗可缓解临床症状,改善预后,效果良好。

Objective To summarize the clinical and imaging characteristics for cerebral venous sinus thrombosis in order to improve the early diagnosis rate and decrease the misdiagnosis and mortality.Methods The clinical and imaging data of 48 cases with cerebral venous sinus thrombosis were retrospectively analyzed from May 2009 to January 2011. Results The patients with CVST had diverse clinical manifestations, with headache as the initial symptom. Its diagnosis mainly relied on CT, MRI, MRV and DSA image. After anticoagulation, reducing intracranial pressure and other treatment, the intracranial pressure of CVST was significantly decreased, with 26 cases （54.17%） cured, 14 cases （29.17%） improved and 8 cases （16.66%） invalid.Conclusion The causes of CVST are sophisticated and the forms ware various, with no specific clinical manifestations. Headache, vomiting, with or without clinical features of neural function defect focal are the most common clinical symptom.Combined with CT , MRI and MRV, even with DSA, CVST can be diagnosed. The early use of antithrombotic therapy can relieve clinical symptoms, improve the prognosis and receive effective treament.