颅内静脉窦血栓回顾性临床研究

Retrospective Clinical Research of Intracranial Venous Sinus Thrombosis

目的:探讨颅内静脉窦血栓(CVST)形成的危险因素、临床表现、影像学检查、诊治及影响预后的因素等。方法:回顾性分析2010年8月~2016年4月经确诊的30例CVST患者的危险因素、临床表现、脑脊液、头颅CT、MRI、MRV及预后评估等。结果:CVST发病因素较多,部分患者合并多个危险因素;头痛、视物模糊、意识障碍、精神障碍、癫痫等为常见临床表现;头颅MRI+MRV是目前CVST检查最常用的诊断手段,DSA检查为金标准;肝素抗凝安全有效。结论 :CVST临床症状多变且无特异性,头痛为主要临床表现,头颅MRV可提高诊断阳性率,DSA检查为金标准;高颅压、局灶性神经功能障碍、脑出血是本病预后不良的独立危险因素。

Objective： To evaluate the risk factors, clinical manifestations, imaging examination, diagnosis, treatment and the factors influencing prognosis of the formation intracranial venous sinus thrombosis（CVST）. Methods： From August 2010 to April 2016, a retrospective analysis on 30 cases of patients with CVST, the risk factors, clinical manifestations, cerebrospinal fluid, cranial CT, MRI,MRV and prognosis were evaluated. Results： There were many pathogenic factors of CVST, some patients merge multiple risk factors;Headache, blurred vision, disturbance of consciousness, mental disorders, epilepsy, etc, as the common clinical manifestations; head MRI and MRV were now the most common methods for diagnosis of CVST check, DSA examination as the gold standard; Heparin anticoagulation was safe and effective. Conclusion： The clinical symptoms of CVST are variable and nonspecific, headache as the main clinical manifestations, cranial MRV can improve the positive rate of diagnosis, DSA examination as the gold standard; high intracranial pressure、focal neurological dysfunction and cerebral hemorrhage were independent risk prognostic factors of the disease.