脑静脉血栓形成的解剖学与临床特点

Clinical and Anatomical Features of Cerebral Vein and Sinus Thrombosis

目的探讨脑静脉血栓形成（cerebral venous sinus thrombosis,CVT）的解剖和临床特点,以提高早期临床确诊,并及时给予治疗,改善预后.方法回顾性分析76例确诊为CVT的患者,其中男性30例,女性46例,年龄30-50岁,平均（35.6±4.6）岁.登记患者的一般资料、临床症状、影像学、治疗情况和预后.结果脑静脉系统患者的发病年龄较轻,多为中青年,头痛、恶心、呕吐等高颅压症状多为首发症状.引起CVT的常见病因依次为：高凝状态、感染.右侧CVT的临床症状较左侧严重,且颅内高压的症状重,左侧多表现认知功能的下降.治疗上多为扩容、降低颅内压、抗凝治疗（急性期应用低分子肝素、恢复期应用华法令）.应用头颅MRV一般可以明确诊断,CE-MRV的敏感性更高,对于皮层静脉血栓需要行DSA检查,以明确诊断.结论CVT的病因多,症状复杂,发病年龄轻,尽早诊断并给予治疗,预后好.

Objective To analyze the clinical and anatomical features of cerebral vein and sinus thrombosis so as to improve the early clinical diagnosis and treatment in time.Methods The clinical dates of 76 hospitatized patients（medical history,clinical manifestations） with CVT were collected and analiged.Results CVT tended to occur in young adults.Headache, nausea, vomiting and such cranial pressure symptoms were the frist symptoms.The common cause of CVT was high coagulation state and infection.The treatment included the expansion, reduction of intracranial pressure, anticoagulation（low molecular heparin in acute, warfarin in recovery）.Application of MRV could generally make the diagnosis clear.The sensitivity of the CEMRV was higher it was necessary but to cortical vein thrombosis DSA examination.Conclusion It is difficult to recognize CVT at an early stage due to its diverse clinical presentations.The prognosis will be good when the diagnosis and therapy are performed as soon as possible.