颅内静脉窦血栓形成2例并文献复习

Intracranial venous sinus thrombosis:two cases report and literature review

目的总结颅内静脉窦血栓形成(CVST)的临床特点,提高对该病的早期诊断和治疗水平。方法分析2例CVST的临床特点、影像学和实验室检查资料及治疗效果。结果 2例患者均为男性,分别为48岁、63岁。1例有眼球感染,另1例无明显诱因。2例均有头痛等神经系统症状,病情迅速加重。2例头颅CT检查均出现两侧大脑半球肿胀,局部出血灶和明显占位效应,1例数字减影血管造影(DSA)示局部静脉、静脉窦不显影。1例腰椎穿刺颅内压升高,呈血性脑脊液。2例患者经抗凝等综合治疗均获得良好疗效。结论 CVST以头痛等症状为主要表现,病情进展迅猛,头颅CT表现为两侧大脑半球肿胀,局部出血,占位效应明显,早期诊断及治疗效果好。

Objective To summarize the clinical features of intracranial venous sinus thrombosis （CVST）,as well as to improve the early diagnosis and treatment.Methods The clinical characteristics,imaging,laboratory examination data and the treatment effect of CVST were retrospectively analyzed.Results The two patients were male,28 and 30 years old.One patient with eye infection,and no obvious cause in the other one.Headache and other neurological symptoms were found in both cases,and the patients＇condition rapidly worsened.Head CT scan showed cerebral hemispheric swelling in both cases,local hemorrhage and obvious space occupying effect.Partial vein and venous sinuses of one casewere not visualized with DSA.Lumbar puncture identified increased intracranial pressure, and bloody cerebrospinal fluid was obtained.Two patients were treated well after anticoagulant and comprehensive treatment.Conclusion CVST was characterized by headache and other neurological symptoms,and the disease developed rapidly.Cerebral hemispheric swelling,local bleeding and obvious space occupying effect were found by head CT.It can be treated well in the early stage of diagnosis.