脑静脉窦血栓形成60例临床分析  

Clinical Analysis of Sixty Cases with Cerebral Vein and Sinus Thrombosis

作　　者：姜家珍[1] 丁宏岩[2] 董强[2] 

机构地区：[1]复旦大学附属华山医院中心ICU,上海200040 [2]复旦大学附属华山医院神经内科,上海200040

出　　处：《神经损伤与功能重建》2010年第2期97-101,共5页Neural Injury and Functional Reconstruction

摘　　要：目的:分析脑静脉窦血栓形成(CVST)的临床特点。方法:回顾性分析60例CVST患者的临床资料。结果:本组患者多为急性、亚急性起病;头痛48例(80%),癫23例(38.3%),出现视觉症状22例(36.7%),出现局灶性神经受损症状16例(26.7%),意识障碍9例(15%);影像学表现为以皮质为主的梗死或水肿,可伴发出血,行磁共振静脉成像(MRV)检查48例(80%),行数字减影血管造影(DSA)40例(66.7%),血管造影证实存在静脉和/或静脉窦狭窄或闭塞;抗栓治疗56例(93.3%),其中抗凝治疗51例(91.1%);痊愈51例(85%),好转7例(11.7%),脑疝形成2例(3.3%),自动出院。结论:认识其临床特征并及时行MRV检查是正确诊断CVST的关键,治疗以抗凝为主,需及早治疗。Objective： To analyze the clinical characteristics of cerebral vein and sinus thrombosis （CVST）. Methods： All the medical records, including sex, age, clinical manifestations, findings of neuroimaging, treatment and prognosis were analyzed retrospectively in sixty cases of CVST from Jan. 2003 to Dec. 2009 in Huashan Hospital. Results： Of the 60 cases （35men,25 women） ,aged from 8 to 73 （mean 35.5±14.6） years old. Most patients had acute or subacute onset. Forty-eight cases （80%） had headache, 23 cases （38.3%） had epilepsy, 22 cases （36.7%） had visual symptoms, 16 cases（26.7%）had focal deficits, and 9 cases（15%）had conscious disturbance. CT or MR imaging showed cortical infarction or edema, often accompanied by hemorrhage. Veins and sinus stenosis or occlusion showed by angiography. Fifty-six cases （93.3%） were treated by antithrombosis methods. Among them, 91. 1% were treated with anti- coagulation. After the treatment, 51 cases （85%） recovered completely, 7 cases improved, and 2 cases discharged for brain herniation. Conclusion： Increased consideration of CVST and prompt MRV and MRI examination are the key to accurate diagnosis and timely therapy. The treatment of CVST should be based on anticoagulation.

关 键 词：脑静脉窦血栓形成 临床特点 治疗 

分 类 号：R741[医药卫生—神经病学与精神病学] R743.32[医药卫生—临床医学]