脑静脉窦血栓形成20例临床分析

Clinical analysis on 20 cases with cerebral venous sinus thrombosis

目的探讨脑静脉窦血栓(CVST)形成的临床及影像学特点。方法分析20例脑静脉窦血栓形成患者的临床及影像学资料。结果多为亚急性起病13例(65%);病因以非感染因素13例为主(65%),头痛17例(85%)、视乳头水肿12例(60%)、血浆D-二聚体增高14例(70%),行磁共振静脉成像(MRV)的19例均阳性(100%);累及最多上矢状窦18/42支(42.8%),累及2支以上12例(60%)。及时抗凝治疗预后良好。结论 CVST是神经系统急症,临床表现复杂,医师考虑病人为CVST应及时做MRV多可明确诊断,抗凝治疗安全有效。

Objective To investigate the clinical and imaging characteristics of cerebral venous sinus thrombosis( CVST).Methods The clinical and imaging data of 20 CVST patients were analyzed. Results Most of CVST onsets were subacute( 13 cases,65%). Most of predisposing factors were non-infection( 13 cases,65%). The first onset symptoms were headache( 17 cases,85%).Papilledema( 12 cases,60%).The level of plasma D-two dimer was increased( 14 cases,70%). Magnetic resonance angiography( MRV) was applied in 19 cases and all showed intravenous abnormal signal( 100%). Most of patients MRV showed more than 2 intravenous abnormal signals. The prognosis is good when anticoagulant therapy timely.Conclusion CVST is an emergency disease in nervous system.Clinical manifestations complex.If the patient is suspect to CVST,MRV should be checked in time and make a confirm diagnosis.Anticoagulant therapy is safe and effective.