颅内深静脉血栓形成的临床诊治  

Clinical diagnosis and treatment of intracranial deep venous thrombosis

作　　者：周建 钟旺旺 陈五研 陈贤妃 王守森 ZHOU Jian;ZHONG Wang-wang;CHEN Wu-yan;CHEN Xian-fei;WANG Shou-sen(Department of Neurosurgery,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Neurology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Radiology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Neurosurgery,Fujian Medical University Fuzong Clinical College(the 900th Hospital),Fuzhou 350025,China)

机构地区：[1]海南医学院第一附属医院神经外科,海口570102 [2]海南医学院第一附属医院神经内科,海口570102 [3]海南医学院第一附属医院放射科,海口570102 [4]福建医科大学福总临床医学院(第900医院)神经外科,福州350025

出　　处：《中国临床解剖学杂志》2020年第5期523-527,共5页Chinese Journal of Clinical Anatomy

基　　金：福建省科技计划引导性项目(2014Y0036);福建省科技创新联合资金重大项目(2019Y9045)。

摘　　要：目的探讨颅内深静脉血栓形成(deep cerebral venous thrombosis,DCVT)的临床诊断与治疗策略。方法回顾性分析10年来影像学诊断为DCVT的5例患者的临床表现、影像学特征、治疗及预后情况。结果DCVT最常累及Rosenthal基底静脉、大脑内静脉、Galen静脉和直窦,其临床表现不典型,常见有头痛、意识障碍、复视、偏瘫等,常见诱发因素有口服避孕药、产褥期、妊娠期等。丘脑水肿为DCVT患者最常见的影像学征象。肝素抗凝治疗简单有效,大脑深静脉可恢复再通,临床症状缓解。结论DCVT患者临床症状缺乏特异性,早期诊断困难,特殊成像技术和特定影像学特征有助于其明确诊断,及时正确的抗凝治疗可获得良好的预后。Objective To investigate the clinical diagnosis and treatment strategy of deep cerebral venous thrombosis(DCVT). Methods A total of 5 DCVT patients were enrolled during the past 10 years.The clinical manifestations, imaging features, treatment and prognosis were retrospectively analyzed.Results DCVT commonly was involved in the internal cerebral veins, vein of Galen, straight sinus, or basal vein of Rosenthal. However, the clinical manifestations of DCVT were atypical. Among patients seen in neurology clinics, headache, disturbance of consciousness, diplopia, and hemiplegia were common manifestations. Oral contraceptives, pregnancy, and puerperium were the common risk factors. Thalamic lesions were the common radiologic sign of DCVT. Heparin offered a simple and effective therapy to prevent blood clots in extended treatment after DCVT, leading to their gradual recovery, with recanalization of the deep venous system. Conclusions The clinical symptoms of DCVT patients are non-specific, and DCVT in the early stages is particularly hard to diagnose. Specific attention should be given to the specific imaging features which could help to diagnose DCVT. The DCVT patients will achieve a better outcome following timely anticoagulant treatment.

关 键 词：颅内深静脉血栓形成 基底静脉 大脑内静脉 GALEN静脉 直窦 影像学 治疗 

分 类 号：R743.9[医药卫生—神经病学与精神病学]