感染性脑静脉窦血栓的临床分析  

Clinical Analysis of Inflammatory Cerebral Venous Sinus Thrombosis

作　　者：支兴龙[1] 王建祯[1] 凌锋[1] 吉训明[1] 李慎茂[1] 缪中荣[1] 朱风水[1] 何心[1] 

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国临床神经外科杂志》2007年第4期214-216,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨感染性脑静脉窦血栓(CVST)的特点及治疗策略。方法对10例由感染所致的CVST患者的病因、诊断、治疗情况进行回顾性分析。结果10例患者中,4例继发于乳突感染,2例继发于头面部疖肿感染,3例继发于中耳炎,1例由单纯疱疹病毒性脑炎导致。患者最初主要为头痛、发热等局部感染表现,进而出现颅内压增高及神经系统症状。实验室检查白细胞升高,头部CT、MRI、DSA等检查显示患者有不同程度的脑静脉窦闭塞。10例患者均行抗感染治疗,其中6例给予抗凝治疗,4例给予局部溶栓治疗。治疗后患者痊愈7例,好转2例,死亡1例。结论头面部感染及全身性菌血症患者,如出现颅内压增高等神经系统症状时应考虑CVST,早期诊断及治疗可以明显改善患者预后。Objective To explore the clinical characteristics and treatment of inflammatory cerebral venous sinus thrombosis （ICVST）. Methods The clinical data of 10 patients with ICVST, which were related to the pathogeny, diagnosis and treatment, were analyzed retrospectively. Results Of 10 cases of ICVST, 4 were caused by mastoiditis, 2 by the furuncles on their faces, 3 by otitis media and 1 was secondary to herpes simplex virus encephalitis. First came infections manifestations including headache, fever and so on, then intracranial hypertension and neurological disorder in the patients with ICVST. The laboratory examination showed that the number of white blood cells in the peripheral blood were more than the normal in 9 patients. The examinations of CT, MRI, MRV and DSA showed that there was the occlusion of cerebral venous sinus to different extent in all the patients. Antibiotics were give to all the patients, of whom, 6 received anticoagulation therapy and 4 local thrombolysis therapy. After the treatment, 7 patients were recovered well, 2 improved in the clinical symptomas and 1 died. Conclusions When intracranial hypertension and neurology disorders appeared, ICVST should be considered in the patients with head or face infection. Early diagnosis and treatment can significantly improve the prognosis in the patients with ICVST.

关 键 词：感染 脑静脉窦血栓 抗凝 血管内治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]