Use of MLC901 in cerebral venous sinus thrombosis:Three case reports

BACKGROUND Cerebral venous sinus thrombosis(CVT)is rare cause of cerebrovascular disease.The incidence is 0.5%of all stroke.The majority of affected patients are young adults(mean age:35-40 years)with mild to moderate disabilities.Poor outcome with severe disability is seen in 13%of cases.Early diagnosis and treatment are important for good outcomes and preventing complications.Treatment options are limited and mostly based on consensus.NeuroAiD II™(MLC901;Moleac Pte,Ltd,Singapore)has a potential beneficial role in post-stroke recovery,by aiding the natural brain recovery process.CASE SUMMARY MLC901 consists of nine natural herbal ingredients.Studies have shown its safety profile and aid in post stroke recovery.The aim of this case series was to demonstrate the potential role of MLC901 in stroke recovery of patients with cerebral venous sinus thrombosis(CVST)who received MLC901 in addition to standard of care.The prescribed dose of MLC901 is 400 mg/cap two capsules,three times a day.Data from these patients were prospectively collected at baseline and at monthly visits,for a duration of 3 mo.Outcome measures included adherence to therapy,side effects,National Institutes of Health Stroke Scale,Glasgow Coma Scale,modified Rankin Scale,and the Short Orientation-Memory-Concentration Test.MLC901 was well tolerated and no side effects were reported.All patients were stable with improved condition.CONCLUSION This case series highlights the potential therapeutic effects of MLC901 on CVST and provides support for further studies.

Rare cause of cerebral venous sinus thrombosis:Spontaneous intracranial hypotension syndrome:A case report

BACKGROUND Spontaneous intracranial hypotension syndrome is a relatively uncommon neurological disorder of unknown etiology with a good prognosis.Cerebral venous sinus thrombosis is a specific type of cerebrovascular disease caused by multiple etiologies of cerebral venous sinus or vein thrombosis that obstructs cerebral venous return and is associated with impaired cerebrospinal fluid absorption;this entity is rarely seen clinically.Spontaneous intracranial hypotension syndrome is one of the causes of cerebral venous sinus thrombosis,and the probability of their combined occurrence is only 1%-2%.As such,it is easily overlooked clinically,thus increasing the difficulty of diagnosis and treatment.CASE SUMMARY A 29-year-old young woman presented with postural headache.Lumbar puncture suggested a pressure of 50 mmH2O(normal 80 mmH2O-180 mmH2O),and magnetic resonance imaging cerebral venography suggested thrombosis of the supratentorial sinus.These findings were considered indicative of cerebral venous sinus thrombosis due to spontaneous intracranial hypotension syndrome after ruling out immunological causes,tumor,infection,abnormal coagulation mechanism,and hypercoagulable state,etc.She was treated with rehydration and low-molecular heparin anticoagulation for 15 d,and follow-up magnetic resonance imaging cerebral venography suggested resolution of the thrombus.The patient had complete improvement of her headache symptoms.CONCLUSION Spontaneous intracranial hypotension syndrome is one of the rare causes of cerebral venous sinus thrombosis,which is frequently misdiagnosed or missed and deserves consideration by clinicians during differential diagnosis.Dehydration should be avoided in such patients,and early rehydration and anticoagulation therapy are effective treatment options.

Sneddon's syndrome concurrent with cerebral venous sinus thrombosis:A case report

BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with Sneddon's syndrome(SS)and cerebral venous sinus thrombosis(CVST).Particular emphasis is placed on the comprehensive elucidation of SS's clinical manifestations,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A 26-year-old woman presented with recurrent episodes of paroxysmal unilateral limb weakness accompanied by skin mottling,seizures,and cognitive impairment.Digital subtraction angiography revealed CVST.Despite negative antiphospholipid antibody results,skin biopsy indicated chronic inflammatory cell infiltration.The patient was treated using anticoagulation,antiepileptic therapy,and supportive care,which resulted in symptom improvement.The coexistence of SS and CVST is rare and the underlying pathophysiology remains uncertain.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of SS with CVST and reviewed the relevant literature to improve the clinical understanding of this rare condition.

An Early Pregnant Chinese Woman with Cerebral Venous Sinus Thrombosis Succeeding in Induction of Labor in the Second Trimester

Cerebral venous sinus thrombosis(CVST)is a rare condition in early pregnancy.A22-year-old Chinese woman at10weeks of pregnancy requested induced abortion and was diagnosed as CVST for a severe headache accompanying with nausea and vomiting.The patient was treated successfully with anticoagulation,followed by amniocentesis,and finally succeeded in induction of labor safely.The diagnosis,treatment and prognosis for this rare condition are discussed in this paper.

Cerebral venous sinus thrombosis following transsphenoidal surgery for craniopharyngioma:A case report

BACKGROUND Cerebral venous sinus thrombosis(CVST)is a rare condition in patients with craniopharyngioma following transsphenoidal surgery.CASE SUMMARY A 56-year-old man who underwent transsphenoidal surgery for craniopharyngioma 26 d ago presented gradual headache and cerebrospinal fluid leakage while vomiting 5 d post-discharge and required readmission to our department of neurosurgery.After admission,head imaging examination showed a hyperdense shadow in the superior sagittal sinus and right transverse sinus,edema at the bilateral parietal lobe,and hemorrhage at the left parietal lobe and right occipital lobe;the venous phase of cerebral angiography revealed CVST.The patient was treated immediately by intravenous thrombolysis,endovascular thrombolysis,and mechanical thrombectomy after the definite diagnosis.However,the neurological status of the patient continued to deteriorate and he died on the fourth day after readmission.CONCLUSION For craniopharyngioma undergoing transsphenoidal surgery,it is vital to take an effective strategy to manage the postoperative complications,such as diabetes insipidus,severe electrolyte imbalance,and cerebrospinal fluid leakage.Additionally,the early differential diagnosis of CVST is essential when it develops clinical symptoms,especially in patients following transsphenoidal surgery with a high risk of CVST.Subsequently,the timely and effective treatment of the CVST is critical for preventing neurological deterioration.

Hypereosinophilia with cerebral venous sinus thrombosis and intracerebral hemorrhage:A case report and review of the literature

BACKGROUND Hypereosinophilia(HE)is defined as a peripheral blood eosinophil count of>1.5×109/L and may be associated with tissue damage.The clinical presentations of HE vary;however,myocardial fibrosis and thrombosis can threaten the lives of patients with sustained eosinophilia.Cerebral venous sinus thrombosis(CVST)in the setting of eosinophil-related diseases has seldom been reported.Here,we review the literature on HE with CVST to increase knowledge and encourage early diagnosis.CASE SUMMARY A previously healthy 41-year-old man was admitted to hospital with diarrhea and abdominal pain.He was treated with antibiotics for suspected acute colitis.Three days later,he experienced headache and vomiting.Brain computed tomography(CT)revealed thrombosis of the left jugular vein to the left transverse sinus vein.Platelet(PLT)count decreased to 60×1012/L,and absolute eosinophil count(AEC)increased to 2.41×109/L.He was treated with low-molecular-weight heparin.PLT count progressively decreased to 14×109/L,and we terminated anticoagulation and performed PLT transfusion.Six days after admission,he complained of a worsening headache.Brain CT revealed right temporal lobe and left centrum semiovale intracerebral hemorrhage,and AEC increased to 7.65×109/L.We used prednisolone for HE.The level of consciousness decreased,so emergency hematoma removal and decompressive craniectomy for right cerebral hemorrhage were performed.The patient was alert 2 d after surgery.He was treated with anticoagulation again 2 wk after surgery.Corticosteroids were gradually tapered without any symptomatic recurrence or abnormal laboratory findings.CONCLUSION HE can induce CVST,and we need to focus on eosinophil counts in patients with CVST.

Common Prothrombotic Gene Mutations in Cerebral Venous Sinus Thrombosis in North-West of Iran

Objective: Cerebral venous sinus thrombosis (CVST) is a life-threatening cerebrovascular disease which has high prevalence and mortality rate in Iran. Thrombophilia caused by gene mutation is a common cause of CVST. The present study aimed at assessing the prevalence of thrombophilic gene mutations in Iranian CVST patients and then comparing it with normal population. Materials and methods: In a case-control study, polymerase chain reaction-restriction fragment length polymorphism (PCR_RFLP) and amplification-refractory mutation system (ARMS-PCR) were carried out to detect common thrombophilic mutations in 70 CVST patients. Next, it was compared with 82 sex- and age-matched healthy controls. Results: Factor-V-Leiden, Factor-V-Leiden HR2, Factor prothrombin II, MTHFR (667C/T) and MTHFR (1298A/C) prevalence were significantly high in cases of CVST as compared to the controls (P values: 0.012, 0.019, 0.007 and 0.036, respectively). However, there was no significant difference between the two groups in plasminogen activator inhibitor (PAI), angiotensin-converting enzyme (ACE), beta-fibrinogen (FGB), Factor VIII, Factor XIII, and tissue plasminogen activator (tPA) mutations. Conclusion: The findings of the present study suggest that Factor V-Leiden, Factor-V-Leiden HR2, prothrombin II (G20210A), and MTHFR (667C/T & 1298A/C) mutations are more frequent in CVST. Detection of these mutations may help clinicians to decide on the duration of treatment and referral to genetic counseling for valuable prevention.

Accuracy of Noncontrast CT Brain in Detection of Cerebral Venous Sinus Thrombosis

Background and Purpose: Increasing concern of cerebral venous thrombosis due to treatable and curable causes of stroke. The diagnosis of cerebral venous sinus thrombosis is challenged due to nonspecific clinical symptomatology. Patients may present at an emergency room with a variety of neurological conditions such as severe headache, weakness, seizure, etc. Neuroimaging, particularly noncontrast cranial computed tomography (NCCT), is an investigation of choice in differentiation and triage the patients for further treatment. CT is sensitive in the detection of acute thrombosis or blood clots in all regions of the body. We hypothesize that NCCT might be sensitive to diagnose cerebral venous thrombosis immediately. Materials and Methods: Retrospectively review the electronic database of our patients, there are 27 patients with cerebral sinus venous thrombosis (SVT) and 4 patients with cerebral deep venous thrombosis (DVT). Other 79 patients present with clinically diagnosed cerebral venous thrombosis but the final result can exclude cerebral venous thrombosis. We use MR imaging and CT venography as the gold standard. Independently reviewed by two neuroradiologists for CT direct sign and CT indirect signs that suggest SVT or DVT. CT direct signs for SVT and DVT are the presence of hyperdensity in the sinus venous or deep venous system (cord sign, attenuated vein sign) and CT indirect signs are the changes in brain parenchyma (brain edema, hemorrhagic infarction). Results: Sensitivity and specificity of NCCT in detection attenuated vein sign and diagnosis DVT are 75% and 100% whereas the sensitivity and specificity of NCCT in detection cord sign and diagnosis SVT are 43.8% and 99.7% as respectively. Conclusions: NCCT might not sensitive in detection of SVT without CT direct sign which needs further investigation. However, NCCT might beneficial for emergency conditions such as DVT patients, cortical vein thrombosis and also in SVT patients with the positive CT direct sign.

A Case Report on Atypical Presentation of Cerebral Venous Sinus Thrombosis, a Young Adult with Recurrent Fall: A Clinical Quandary

Cerebral Venous Sinus Thrombosis (CVST) is blood clot in draining veins and venous sinuses of brain, causing hindrance in the blood drainage system in brain, disturbing the internal homeostasis of brain, resulting in local oedema, ischemia, venous haemorrhage, damage to brain parenchyma and blood brain barrier. In our case report, we discussed a rare presentation of CVST, a 16-year-old young boy who presented in emergency with history recurrent fall, weakness, tingling numbness. What makes it challenging to diagnose in his unusual presentation without common symptoms and on examination no positive neurological finding. This case brings focus on the importance of knowledge about CVST among emergency physicians. CSVT is considered more commonly as a differential diagnosis of stroke in young age group owning to genetic predisposition, hot humid climate of the state leading to severe dehydration, dietary factors leading to vitamin B12 deficiency & hyper-homocysteinemia etc. Moreover, present COVID-19, inducing a hypercoagulable state among affected individuals gave CVST a new momentous among emergency physicians. An early diagnosis can be very fruitful as it might prevent long term disability and reduce mortality significantly.

Antithrombin gene Arg197Stop mutation-associated venous sinus thrombosis in a Chinese family

This study sought to elucidate the genetic correlation of cerebral venous sinus thrombosis caused by a hereditary antithrombin deficiency in a Chinese family, at the genetic and protein levels. A nonsense mutation from C to T on locus 6431 in exon 3B of the antithrombin gene was observed, leading to an arginine （CGA） to stop codon （TGA） change in the protein. This is the first report of this mutation in China. Ineffective heparin therapy in the propositus patient is associated with a lack of heparin binding sites after antithrombin gene mutation. Characteristic low intracranial pressure in the acute phase might be specific to this patient with cerebral venous sinus thrombosis.

Two cases of venous sinus thrombosis in women taking the oral contraceptive pill, Yaz (dropirenone/ ethinyl estradiol), and review of the literature

Cerebral venous sinus thrombosis (CVT) is a rare cause of stroke and the clinical presentation is variable, thus mimicking other neurologic pathologies. One of the more common acquired risk factors of venous sinus thrombosis is oral contraceptive medications such as Yaz. While the prognosis for CVT is favorable, it is important to identify and treat early to prevent neurologic deficits. We report two cases of young female patients who presented with sinus thrombosis and review the current literature on this topic. CVT accounts for 0.5% of strokes and most commonly presents with headaches and in many cases focal neurologic deficits. Diagnosis is confirmed with neuroimaging including CT angiography or MR angiography. Treatment consists of anticoagulation and in some cases, thrombolytic therapy is beneficial. The overall prognosis of CVT is favorable but, further research is needed to outline optimal treatment options including the duration of anticoagulation therapy and the role of thrombolytic therapy to prevent serious neurologic deficits.

Patients with SERPINC1 rs2227589 polymorphism found to have multiple cerebral venous sinus thromboses despite a normal antithrombin level:A case report

BACKGROUND The hereditary antithrombin(AT)deficiency caused by SERPINC1 gene mutation is an autosomal dominant thrombotic disorder.An increasing number of studies have shown that mutations in the SERPINC1 rs2227589 polymorphic site are correlated with a risk of venous thromboembolism(VTE)at common sites,such as lower extremity deep venous thrombosis and pulmonary thromboembolism.Currently,there are no reports of cerebral venous sinus thrombosis(CVST),a VTE site with a low incidence rate and rs2227589 polymorphism.CASE SUMMARY Here,we report a Chinese CVST case with a mutation of the SERPINC1 rs2227589 polymorphic site,which did not cause significant AT deficiency.In a 50-year-old male patient presenting with multiple cerebral venous sinus thromboses no predisposing factors were detected,although a relative had a history of lower extremity deep venous thrombosis.We performed sequencing of the SERPINC1 gene for the patient and his daughter,which revealed the same heterozygous mutation at the rs2227589 polymorphic site:c.41+141G>A.CONCLUSION The results showed that more studies should be conducted to assess the correlation between rs2227589 polymorphism and CVST.

A Case Report of Pediatric Cerebral Venous Thrombosis with Undiagnosed Complex Congenital Heart Disease: Tetralogy of Fallot with OS ASD: A Cataclysmic Ending

Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to disturbances the internal homeostasis of brain, raised intracranial pressure, cerebral edema, and 50% of cases will have venous infarction or venous hemorrhage (stroke). CVST although being a Rare disorder but may be more common in children than adults with greater risk in neonatal period i.e. first 28 days of life. Here we are discussing a case of Pediatric CVST in a 7-month-old baby boy who presented to Emergency Room (ER) with recurrent discrete episodes of vomiting, fever, seizures, drowsiness and respiratory distress. The fatal outcome in our child was attributed to delayed presentation in a tertiary care center, hence missed early diagnosis and treatment. In this child the CVST could be result of amalgamation of complex underlying ongoing multiple pathological processes: an acute systemic illness like sepsis, severe dehydration, undiagnosed and untreated complex congenital heart disease, tetralogy of fallot with osteum secondum atrial septal defect, worsening the coagulopathy. It takes this case even more unique. This discussion is to bring focus on the importance of knowledge about CVST amongst emergency physicians and primary care physicians, specially managing this rare disorder with flummox presentation mimicking other more common disorders, especially in pediatric and neonatal population where definitive history and chief complaints are often vague and difficult to obtain, making it more difficult to diagnose. We the authors hence reporting this case with intent to spread awareness of CVST, how to doubt it, detect it and then manage it, especially in places like Chhattisgarh, India, where CVST is not so uncommon. We believe early diagnosis, early presentation to tertiary care center with aggressive early treatment can significantly reduce the mortality. Should the parents brought the baby early to any tertiary care center owing to his complex deteriorating symptoms like high grade fever progressed to drowsiness and seizure episodes, could there be a different outcome for this child as well as his parents.

Research progress and future development trends of venous sinus stents

Venous sinus stent implantation is an emerging endovascular treatment technique effectively applied in diseases such as cerebral venous sinus thrombosis.However,arterial stents are commonly used in clinical practice for venous sinus stent implantation,which is off-label and carries high risks and poor prognosis,highlighting the necessity of developing venous sinus-specific stents.This narrative review discusses the current situation and problems of venous sinus stent implantation and looks forward to the design focus and future development prospects of venous sinus-specific stents.

Movable typing of full-lumen personalized Vein-Chips to model cerebral venous sinus thrombosis

Cerebral venous sinus thrombosis(CVST)is a type of stroke associated with COVID-19 vaccine-induced immune thrombotic thrombocytopenia.The precise etiology of CVST often remains elusive due to the highly heterogeneous nature of its governing mechanisms,specifically,Virchow’s triad that involves altered blood flow,endothelial dysfunction,and hypercoagulability,which varies substantially amongst individuals.Existing diagnostic and monitoring approaches lack the capability to reflect the combination of these patient-specific thrombotic determinants.In response to this challenge,we introduce a Vein-Chip platform that recapitulates the CVST vascular anatomy from magnetic resonance venography and the associated hemodynamic flow profile using the“Chinese Movable Type-like”soft stereolithography technique.The resultant full-lumen personalized Vein-Chips,functionalized with endothelial cells,enable in-vitro thrombosis assays that can elucidate distinct thrombogenic scenarios between normal vascular conditions and those of endothelial dysfunction.The former displayed minimal platelet aggregation and negligible fibrin deposition,while the latter presented significant fibrin extrusion from platelet aggregations.The low-cost movable typing technique further enhances the potential for commercialization and broader utilization of personalized Vein-Chips in surgical labs and at-home monitoring.Future research and development in this direction will pave the way for improved management and prevention of CVST,ultimately benefiting both patients and healthcare systems.

Dural enhancement detected by magnetic resonance imaging reflecting the underlying causes of cerebral venous sinus thrombosis

Dural enhancement detected by magnetic resonance imaging is a common finding in patients with cerebral venous sinus thrombosis （CVST） and is usually interpreted as a change secondary to CVST. We report two cases of CVST with intense and diffuse dural enhancement that resulted from pachymeningitis in one patient and spontaneous intracranial hypotension in another. Pachymeningitis and spontaneous intracranial hypotension were also determined to be the underlying causes of CVST. The clinical data of these two patients are described. In patients with CVST, dural enhancement is not always a secondary change to CVST. It can be a manifestation of the underlying causes of CVST. When diffuse and intense dural enhancement is revealed, sufficient ancillary tests are warranted to rule out other potential patholooical chanoes of the dura mater those can result in CVST.

Development of cerebral venous sinus thrombosis in an aplastic anemia patient with antiphospholipid syndrome

Aplastic anemia （AA） is an acquired disorder in which .bone marrow fails to produce or release sufficient amounts of blood cell. Antiphospholipid syndrome （APS） is an autoimmune disease characterised by recurrent arterial or venous thrombosis, pregnancy morbidity and the persistence of positive antiphospholipid antibodies （aPL）, including anticardiolipin antibody （ACL） and lupus anticoagulant （LA）. 1 The most prevalent neurologic manifestation of APS is cerebrovascular ischemic events due to arterial thromboses. The deep veins of lower extremities are commonly involved in venous thrombosis of APS, but cerebral venous sinus thrombosis is rare with only several cases reported.2-11 AA together with APS is extremely rare.12 Here we report a case of cerebral venous sinus thrombosis in an AA patient with APS.

Cerebral venous sinus thrombosis: a clinical study of 23 cases

To describe the etiologies, clinical features and diagnosis of cerebral venous sinus thrombosis Methods We reviewed the records of 23 patients admitted with a documented diagnosis of cerebral venous sinus thrombosis from 1991 through 1999 in the Beijing Tiantan Hospital Results Infection was the major condition associated with cerebral venous sinus thrombosis Pseudotumor cerebri syndrome was the most common manifestation, while hemiplegia, seizure and unconsciousness may occur alone or in association The diagnostic sensitivity of computed tomography (CT), magnetic resonance imaging (MRI) and digital subtract angiography (DSA) were 59%, 86% and 100%, respectively The sensitivity of MRI with magnetic resonance angiography (MRA) reached 96% Conclusion As the clinical findings were found to be nonspecific, CT combined with DSA, or MRI with MRA turns out to be valuable for the early diagnosis of cerebral venous sinus thrombosis

Non-contrast CT image characteristics on admission predict the 3-month outcome of cerebral venous sinus thrombosis: an observational study in a single institution

Various computed tomography (CT) appearances of cerebral venous sinus thrombosis (CVST) were associated with different prognosis and the patients with large intracranial hematoma will have adverse outcomes, but no in-depth study of non-contrast CT image appearances was carried out. We aimed to test the hypothesis that non-contrast CT image characteristics on admission are associated with and predict the outcome of CVST at 3 months. Methods: Three hundred and six patients with CVST between 2008 and 2017 were col ected. Age, sex, onset of CVST(acute, subacute, or chronic), etiology, clinical manifestations, midline shift, occluded venous sinus, location of infarction, non-contrast CT image characteristics, and the 3-month outcome were recorded. In addition, we established a non-contrast CT image-based classification and grading system to test the hypothesis;the CVST patients were classified into four grades (namely non-contrast CT image-based classification): grade I, no obvious abnormality;grade II, simple vein infarction without hemorrhage or with subarachnoid hemorrhage;grade II , cerebral venous infarction with subarachnoid hemorrhage;and grade IV, cerebral vein infarction with hematoma. Al enrolled patients had received subcutaneous injections of low molecular weight heparin subcutaneous injection for 14 days. Thereafter, oral anticoagulant therapy with warfarin was continued. Patients with epilepsy were given antiepileptic drugs, and patients with cerebral herniation received decompressive craniotomy. Results: Our observational findings revealed that midline shift (> 5 mm), location of lesion (frontal lobe and temporal lobe), and cerebral venous infarction with subarachnoid or hematoma (grade II and IV) were associated with 3-month poor outcome (p < 0.05);the respective increased risks were 12.730 [risk ratio (RR) 12.730, 95% confidence interval (CI) 1.680–96.490, p = 0.014], 46.538 (RR 146.538, 95% CI 6.222–348.079, p = 0.000), 32.549 (RR 32.549, 95% CI 2.180–486.104, p = 0.012), 37.725 (RR 37.725, 95% CI 2.051–693.778, p = 0.015), and 93.164-fold (RR 93.164, 95% CI 11.137–779.328, p = 0.000). However, seizure, hemiplegia, location of occluded venous sinus (super sagittal sinus and deep venous systems), location of infarction (parietal lobe), and non-contrast CT image-based classification (I) were not correlated with the adverse outcome (p > 0.05). Conclusions: Our findings suggested that non-contrast CT image characteristics on admission were associated with and predict the 3-month outcome of CVST. However, the ultimate conclusions need to be confirmed by a large sample of CVST patients at multiple institutions.

磁敏感加权成像(SWI)联合磁共振静脉成像(MRV)在脑静脉窦血栓形成(CVST)早期诊断中的临床应用价值

目的:本研究旨在探讨磁敏感加权成像(susceptibility weighted imaging,SWI)联合磁共振静脉成像(magnetic resonance venography,MRV)对脑静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)早期(急性期和亚急性期)诊断的临床应用价值。方法:回顾性分析2010年至2021年间我院收治的早期CVST患者。所有患者均行MRI及数字减影血管造影(digital subtraction angiography,DSA)检查,MR序列包括T1WI、T2WI、FLAIR、MRV和SWI。诊断金标准为头颅DSA检查。各检查序列发现CVST阳性表现,采用卡方检验分别对SWI、MRV和常规MR序列进行统计学分析。结果:本研究66例CVST患者均由头颅DSA确诊,累及上矢状窦17例,横窦9例,累及多静脉窦40例。DSA图像中发现了118个静脉窦血栓形成节段,常规MR(T1WI、T2WI、FLAIR)发现73(61.9%)个,MRV发现118(100%)个。66例患者中,SWI扫描100%(66/66)发现了小静脉扩张和迂曲引流静脉,明显高于MRV扫描71.2%(47/66)(P<0.001)和常规磁共振扫描47.0%(31/66)(P<0.001)。66例患者中SWI显示77.3%(51/66)有微出血灶,明显高于常规MR扫描43.9%(29/66)(P<0.05)。结论:MRV对CVST的早期诊断比常规MR序列更敏感,可以与DSA结果相媲美,SWI可检测梗死灶处扩张的小静脉、迂曲的引流静脉和点状微出血灶,SWI联合MRV在早期CVST临床诊断中具有重要价值。