脑静脉系统血栓形成宣武医院马欣_演示文稿-.ppt

按部位CVT可分为： ●静脉窦血栓 ●大脑浅静脉(皮层静脉)血栓 ●大脑深静脉血栓 ●小脑静脉血栓 ●颈静脉血栓 各种脑静脉血栓的临床特点 ●上矢状窦血栓 ●侧窦(横窦 及乙状窦)血栓 ●岩上窦及岩下窦血栓 ●直窦血栓 ●海绵窦血栓 脑静脉窦血栓 ●其解剖特点决定了血栓易在此部位形成。 ●此窦是脑皮层静脉循环和脑脊液回流的必经之路。 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） Δ ●多种病因可引起SSST，其中非感染性原因更为多见。 ●临床表现主要是颅内压增高、不同程度的意识障碍、 癫痫发作、运动障碍以及括约肌功能障碍。 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） ●血栓的部位、累及范围和梗阻程度决定了损害情况。 范围广泛，超过上矢状窦2/3以上 位于上矢状窦后方 局限于上矢状窦前段 累及到额叶前部静脉回流 波及到中央回静脉 影响到其它大脑浅静脉 ●起病形式 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） This 58 year-old man complained of a severe headache 12 hours after taking part in the London marathon. He attended the general casualty but no cause was found. He was discharged with a diagnosis of possible migraine. However, the pain persisted and he re-attended the casualty 2 days later. He was found to have bilateral optic disc swellings and an urgent MRI scan was requested. Full blood count revealed high platelet count (thrombocythemia) but otherwise all the other tests were normal 脑静脉 窦血栓 上矢状窦血栓 （superior sagittal sinus thrombosis，SSST） Clinical History: 17-year-old female who presents with a four day history of headaches and a seizure immediately prior to admission. There is no significant past medical history. Findings: An axial noncontrasted CT image through the brain demonstrates cerebral edema within the left frontal lobe and deep gray matter. In addition, there is hyperattenuation within the region of the straight