颅内静脉窦血栓形成-课件.pptVIP

Diagnosis and Management of Cerebral Venus Thrombosis A statement for Healthcare Professionals From The America Stroke Association Cerebral Venus Thrombosis Background CVT represents 0.5%-1% of all stroke CVT usually affecting young individuals Diversity of causes and presenting scenarios Purpous To provide an overeview of cerebral venous sinus thrombosis To provide recommendation for its diagnosis management treatment Anatomay Anatomay Cerebral Venous Sinuses Cerebral Venous Sinuses Factors Prior medical condition :thrombophilias IBS Transient situation: pregnancy、 infection dehydration Selected medications：substanse abuse、 oral contraceptives Unpredictable events:head trauma Clinical features Seizures 40% Bilateral brain involvement,deep venus drainage system eg:bilateral thalamic involvement Slowly progressive symptoms superior sagittal sinus thrombosis，SSST SSST SSST transverse and sigmoid sinus thrombosis (transverse and sigmoid sinus thrombosis) transverse and sigmoid sinus thrombosis superior and inferior petrosal sinus thrombosis straight sinus thrombosis cavernous sinuses 脑浅深静脉血栓 分型 1、进行性颅内压增高 2、突然发生的神经系统局灶性损害，酷似动脉性卒中，常无 癫痫发作。 3、神经系统局灶性损害，有或无癫痫发作及颅内压增高，病 情常在数日内进展。 4、神经系统局灶性损害，有或无癫痫发作及颅内压增高，病 情常在数周或数月内进展。 5、突然出现的头痛，类似蛛网膜下腔出血或短暂性脑缺血发 作，此型较少见。 Laboratory findings Rountine blood work D-Dimer Commom Pitfalls Commom Pitfalls Isolated Headache/Idiopathic Intracranial Hypertension Isolated Mental Status Change 抗凝治疗 治疗效果 有分歧 bienfait(62例)—不肯定 Diaz(203) —治 疗组：91% 非治疗组：36% Einhaupl —肯定 溶栓治疗 ● 治疗时间窗 无严格的时间窗。血栓 机化延迟。 但应遵循愈早愈好的原则 ● 伴有出血的CVT是否能溶栓？ ● 溶栓的危险性？ 溶栓治疗 抗凝 * * 刘娟丽 Background 1 Purpose 2 Anatomy 3 Diagnosis and management 5 Risk factors 4 Treatment options 6 脑静脉吻合支较动脉丰富得多 the superior sagittal sinus (green), inferior sagittal sinus (light blue), straight sinus (dark purple), confluence of the sinuses (orange), t