静脉性脑梗死的临床和影像特点分析  

Clinical and imaging characteristics of venous cerebral infarction

作　　者：徐武[1] 路敬业 杨峰[1] 郭民旺[1] 周汝娟[1] 何龙锦[1] 

机构地区：[1]扬州大学医学院附属泰兴人民医院神经内科,泰兴225400

出　　处：《中国实用神经疾病杂志》2014年第5期8-11,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析静脉性脑梗死的临床与影像学特点,旨在提高认识以利于早期诊断和治疗。方法回顾性分析2例静脉性脑梗死的临床表现、影像特征。结果 1例急性起病,以偏瘫、癫痫发作为主要表现,头MRI示双侧多发梗死或出血性梗死灶,且随着病情的好转病灶可缩小甚至消失。1例亚急性起病,进行性加重,主要表现为意识水平的下降,头MRI示双侧弥漫分布的多发DWI高信号病灶,增强示脑膜强化,脑表面血管增多。2例患者病初均有头痛症状。结论早期头痛症状、头MRI示双侧多发梗死或出血性梗死灶、双侧多发DWI高信号病灶、增强示脑膜强化、脑表面血管增多等临床和影像特点有助于静脉性脑梗死的早期诊断。Objective To characterize the clinical and imaging patterns of venous cerebral infarction for early diagnosis and treatment. Methods Clinical and imaging data of 2 patients with venous cerebral infarction were reviewed retrospectively. Re- sults One patient presented acute hemiplegia and epilepsy,whose MRI showed multiple focuses of infarction with or without hemorrhage in bilateral cerebral hemisphere. These focuses could grow small or disappear when the patient＇s condition became better. The other patient presented progressive lowering of consciousness. MRI showed multiple high signal intensities on diffu- sion weighed imaging（DWI） in bilateral cerebral hemisphere. Enhanced MRI showed enhancement in the cerebral dura mater and many small vessels on the cortex. The two patients both had headache in the beginning. Conclusion Patients should be suspected to be VCI with headache in the beginning, multiple focuses of infarction with or without hemorrhage, multiple high signal intensities on DWI and enhancement in the cerebral dura mater and many small vessels on the cortex. They should accept the examination of MRV or DSA as soon as possible,in order to make a definite diagnosis.

关 键 词：静脉性脑梗死 脑静脉血栓形成 磁共振成像 弥散加权成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]