表现为单纯性颅内压增高的颅内静脉窦血栓形成20例患者的临床和影像学特点  

Twenty cases of cerebral venous sinus thrombosis presented as isolated intracranial hypertension

作　　者：路阳[1] 崔世磊[1] 颜榕[1] 孙厚亮[1] 王振常[2] 张晓君[1] 

机构地区：[1]首都医科大学附属北京同仁医院神经内科,北京100730 [2]首都医科大学附属北京同仁医院影像中心,北京100730

出　　处：《中华神经科杂志》2013年第2期112-116,共5页Chinese Journal of Neurology

基　　金：北京市高层次卫生技术人才培养资助项目（2009-2-009）

摘　　要：目的观察临床表现为单纯性颅内压增高的颅内静脉窦血栓形成（CVST）患者的临床和影像学特点。方法收集临床表现为单纯性颅内压增高并同时符合CVST诊断标准的患者的临床和影像学资料，并进行回顾性临床病例研究。结果共收集符合诊断标准的CVST患者20例，男女比例为13：7，年龄为（38．3±11．7）岁，体重指数均在正常范围，42．5％（17／40）眼睛视力低于0．1。有可能病因的CVST患者11例（55％），其中头外伤4例，自身免疫性疾病2例，反复流产、上肢静脉炎、中耳炎术后、三叉神经微血管减压术后以及重度阻塞性睡眠呼吸暂停合并继发性真性红细胞增多各1例。各项头颅影像检查综合分析示，CVST患者中侧窦受累者占85％（17／20），上矢状窦受累者占35％（7／20），13例（65％）为孤立性侧窦血栓形成。结论以单纯性颅内压增高为主要表现的CVST患者以青年男性多见，视力损害较重，存在脑外伤等多种诱发因素。其中多数为孤立性侧窦血栓形成，横窦和乙状窦狭窄是其最常见的磁共振静脉成像表现。Objective To investigate the clinical and image features of cerebral venous sinus thrombosis （CVST） presented as isolated intracranial hypertension. Methods The medical records of patients with diagnosis of CVST presented as isolated intracranial hypertension were reviewed. Clinical features and imaging data were retrospectively analyzed. Results Twenty cases of CVST were included, all these patients were clinically presented as isolated intracranial hypertension. The male to female ratio was 13： 7, and the average age was （38. 3 ±11.7） years old. None of the patients was obesity. The visual acuity was lower than 0. 1 in 42. 5% （ 17/40）of the eyes. Possible risk factors relevant to CVST were found in 11 cases （55%）, including head trauma for 4 cases, autoimmune disease for 2 cases, and other causes of single case including spontaneous abortion, phlebitis, otitis media postoperative, trigeminal nerve microvascular decompression surgery and obstructive sleep apnea syndrome. Image analysis showed that lateral sinus thrombosis was involved in 85% （17/20） of the patients, while superior sagittal sinus was involved in 35% （ 7/20 ）, and 65% （ 13/20 ） of the patients were isolated lateral sinus thrombosis. Conclusions Young male predominance is found in CVST patients which presented as isolated intracranial hypertension but severe visual function loss. Risk factors such as head trauma are commonly found in these patients. Most of the patients are isolated lateral sinus thrombosis, with lateral sinus narrowing as the most common abnormal findings in magnetic resonance venogram.

关 键 词：窦血栓形成 颅内 颅内高压 磁共振成像 

分 类 号：R743.32[医药卫生—神经病学与精神病学]