初诊为静脉窦血栓的硬脑膜动静脉瘘5例分析及文献回顾  

Primary diagnosis of venous sinus thrombosis dural arteriovenous fistula and literature review:report of 5 cases

作　　者：王利军[1] 吉训明[2] 张鹏[2] 李慎茂[2] 朱凤水[2] 焦立群[2] 缪中荣[2] 何川[2] 凌锋[2] 

机构地区：[1]天津第四中心医院神经内科,天津300140 [2]首都医科大学宣武医院介入放射诊断治疗科,北京100053

出　　处：《临床荟萃》2012年第4期294-297,F0003,共5页Clinical Focus

摘　　要：目的探讨硬脑膜动静脉瘘(DAVF)误诊、漏诊的原因及与静脉窦血栓(IVST)形成的关系。方法回顾性分析2011年2～7月收治的初诊为IVST最后诊断为DAVF 5例患者的临床资料,分析其误诊、漏诊的原因。结果 5例患者中,3例有高颅压表现,1例为记忆力下降,1例有帕金森综合征表现。均行头颅MRI及磁共振静脉血管成像(MRV)提示IVST,5例经血管内介入栓塞成功治愈,术后均恢复良好,症状减轻。结论 DAVF多继发于IVST,但在诊断IVST时往往忽视DAVF,导致漏诊,延误治疗,故对于高颅压的患者或IVST的患者必须要想到DAVF的可能,避免误诊、漏诊,以争取早诊断、早治疗。Objective To investigate the reason of the misdiagnosis and missed diagnosis of dural arteriovenous fistula（DAVF）,and the relationship between intracranial venous sinus thrombosis（IVST） and DAVF.Methods The clinical data of 5 patients with primary diagnosis IVST then confirmed diagnosis DAVF,who were treated in our hospital from February to July 2011 were analyzed retrospectively,including the neurologic imaging data,clinical manifestation and therapeutic strategies and so on.Results Of 5 patients with DAVF,3 patients presented high cranial pressure symptoms,1 patient showed memory decline,the other 1 patient had Parkinson syndrome.All patients in MRI and MRV inspection suggested IVST,all 5 patients were successfully cured after intervention embolization,and after the operation,the patients rehabilitated well and the symptom alleviated.Conclusion Most DAVF are secondary to IVST,but in diagnosis of IVST,negligence for DAVF always appears,resulting in misdiagnosis and missed diagnosis,finally,delaying treatment,so for the high cranial pressure or venous sinus thrombosis patients,the possibility must be in mind.

关 键 词：动静脉瘘 窦血栓形成 颅内 栓塞 治疗性 诊断 鉴别 

分 类 号：R364.15[医药卫生—病理学]