脑静脉窦血栓形成26例临床研究.docVIP

脑静脉窦血栓形成26例临床研究[摘要] 目的：探讨脑静脉窦血栓形成（CVST）的临床表现、影像学特征及预后。方法：回顾性分析26例CVST患者的临床表现、实验室资料、影像学特征、治疗经过及预后。结果：26例中，早期表现以头痛为主20例。脑脊液压力增高者24例，脑脊液蛋白和白细胞数正常或轻度升高；典型病例颅脑CT可见到血栓局部条索状高密度影或伴有出血和水肿。MRI平扫可见病变静脉窦异常血栓信号。MRV和DSA可见病变静脉窦显影不良或不显影。经降颅压、抗凝及对症治疗，部分病例行溶栓治疗，18例好转出院(69.2%)；痊愈3例(11.54%)，DSA显示静脉窦完全再通；死亡1例(3.85%)；另有4例患者因病情危重，家属放弃治疗自动出院，总有效率80.8%。结论：CVST临床表现缺乏特异性，确诊有赖于影像学检查，抗凝溶栓是主要的治疗方法。 [关键词] 脑静脉窦血栓形成；临床表现；影像学；抗凝 [中图分类号] R743.32 [文献标识码]A [文章编号]1673-7210（2008）06（c）-060-02 Clinical analysis of 26 patients with cerebral venous sinus thrombosis CHEN Yong-qing, LI Peng-long, YANG Xiao-yu （Department of Laiyang Central Hospital, Yantai265200,China） [Abstract] Objective: To explore the clinical feature, imaging feature and prognosis of cerebral venous sinus thrombosis（CVST）.Methods: Retrospective analysis on the clinical features, laboratory data, neuroimaging changes, treatment and prognosis in 26 CVST patients.Results:20 out of all 26 patients were presented headache. The intracranial pressure increased obviously in CVST patients, while the protein concentration and white blood cell count in CSF were normal or increased slightly. High density like trabs was found by CT scan in typical case and some with edema or hemorrhage.Abnormal signals of thrombus were always found on magnetic resonance imaging(MRI) of brain. Poor visualization or nonvisualization of venous sinus were found on magnetic resonance venography(MRV) and digital subtraction angiography(DSA).18 of 26 patients improved, 3 of 26 patients recovered after the treatment with anticoagulant, decreasing the intracranial pressure, other symptomatic treatment and some thrombolysis.The total effective ratio accounted for 80.8%. Conclusion:Cerebral venous sinus thrombosis has no specific clinical feature. Neuroimaging examination acts as a key role on the final diagnosis. Anticoagulation and thrombolysis are safe and effective therapy. [Key words] Cerebral venous sinus thrombosis;Clinical feature;Neuroimaging;Antico