脑深部静脉血栓形成16例临床分析  

Clinical Features of Sixteen Patients with Deep Cerebral Venous Thrombosis

作　　者：张志[1] 肖剑伟[1] 张娟[1] 黄宗青[1] 刘洪涛[1] 周国强[1] 朱双根[2] 李慎茂[3] 

机构地区：[1]广东医学院附属福田人民医院神经内科,广东省深圳市518033 [2]合肥市第一人民医院神经内科,230061 [3]首都医科大学宣武医院介入中心,北京市100053

出　　处：《中华全科医学》2013年第6期865-866,922,共3页Chinese Journal of General Practice

摘　　要：目的探讨脑深部静脉血栓形成的临床表现、影像学特点和治疗方法。方法对16例脑深部静脉血栓形成病例的临床资料进行回顾性分析。结果本组临床表现主要有头痛13例(81%),嗜睡11例(69%),昏迷2例(12%),意识障碍总共13例(81%),其他神经系统局灶症状主要有抽搐及视物成双。影像学表现主要为丘脑水肿(87.5%)。DSA是诊断的金标准,可以发现脑深部静脉引流障碍。治疗方法包括血管内治疗、抗凝及对症处理。本组临床症状显著改善14例(87.5%),死亡1例。结论脑深部静脉血栓形成常见临床表现为头痛和意识障碍。多模式影像学检查有助于早期诊断,丘脑水肿是其常见表现。早期血管内治疗及抗凝,预后较好。Objective To investigate the clinical characteristic,image findings and treatment of patients with deep cerebral venous thrombosis（DCVT）. Methods To retrospectively analyze the clinical data of 16 patients with DCVT from Futian people＇ s hospital, Hefei Municipal First People＇ s Hospital and Beijing Xuanwu Hospital. Results The clinical presentation was highly variable with headache （81% ） and reduced consciousness （81% ） as the most frequent symptoms, followed by somnolence （69%） and coma（ 12% ） ,the con^adsion and diplopia were the other common local symptoms of nervous system. Thalamic edema was the most frequent parenchymal MRI finding present in 87.5% of patients. DSA was still the golden standards for the diagnosis of thrombosis of the deep venous drainage of the brain. The treatment methods included the endovascular treatment, anticoagulant therapy and symptomatic treatment. After treatment, clinically significant of 14 cases were improved with an effective rate of 87.5%, 1 case died with a mortality rate of 6.2%. Conclusion Headache and reduced consciousness are the common features of DCVT. The multi-modality image examination can be used as the preferred methods for early diagnosis. Thalamic edema was the most frequent feature. The early endovascular therapy including thrombosis and anticoagulant are the main treatment of DCVT with a better prognosis.

关 键 词：脑深部静脉血栓形成 临床表现 治疗 

分 类 号：R743.32[医药卫生—神经病学与精神病学]