11例颅内静脉血栓形成的临床诊断及治疗转归分析  

Clinical diagnosis, treatment and outcome of cerebral vein thrombosis： analysis of 11 cases

作　　者：鲍娟[1] 杨晓苏[1] 龙小艳[1] 夏健[1] 杨欢[1] 李静[1] 杨期东[1] 

机构地区：[1]中南大学湘雅医院神经内科,长沙410008

出　　处：《中华神经医学杂志》2009年第9期923-925,共3页Chinese Journal of Neuromedicine

摘　　要：目的总结分析颅内静脉血栓形成的临床表现、影像学特征及治疗方法，为该疾病的诊断和治疗提供参考。方法对自2002年至2007年湘雅医院神经内科收治的11例颅内静脉血栓形成患者的临床表现、实验室资料、影像学特征、治疗经过及预后进行回顾性分析。结果10例患者临床表现为非特异性的头痛，其次为呕吐、肢体偏瘫、脑膜刺激征、抽搐等。确诊前有2例曾分别诊断为脑出血、蛛网膜下腔出血。11例患者均行头颅CT和（或）MRI，8例行MRV检查，1例行DSA，明确诊断为静脉血栓形成者10例。所有患者均行降颅压治疗，10例患者进行抗凝／抗血小板治疗，9例好转，1例加重，1例死亡。结论颅内静脉血栓形成临床表现缺乏特异性，误诊率高，确诊有赖于影像学检查。早期抗凝治疗是一种安全有效的方法。Objective To analyze the clinical manifestations, radiographic characteristics and treatment of cerebral vein thrombosis. Methods The clinical manifestations, results of laboratory examinations, characteristic radiographic findings, treatment protocols and outcomes were analyzed retrospectively in 11 patients with cerebral vein thrombosis admitted between 2002 and 2007. Results In 10 of the patients, nonspecific headache was the most frequent symptoms, followed by vomiting, hemiplegia, meningeal irritation and hyperspasmia. Two patients received treatments for suspected cerebral hemorrhage and subarachnoid hemorrhage before a definite diagnosis was established. All thel 1 patients received CT and/or magnetic resonance imaging （MRI） examinations, and 8 also underwent magnetic resonance venography （MRV） and 1 underwent digital subtraction angiography （DSA）, and a definite diagnosis of cerebral vein thrombosis was established in 10 cases. Treatment to control the intracranial pressure was administered in all the patients, among whom 10 were given anti-coagulation or anti-platelet treatments. Nine patients showed improvements after the treatments; 1 had deteriorated condition and 1 died. Conclusion In the absence of specific clinical manifestations, cerebral vein thrombosis gives rise to high rate of misdiagnosis, and a definite diagnosis relies on the findings by radiographic modalities. Early anti-coagulation treatment may prove safe and effective in these cases.

关 键 词：颅内静脉血栓形成 鉴别诊断 治疗 

分 类 号：R686[医药卫生—骨科学]