颅内静脉慢性血栓形成合并硬脑膜动静脉瘘血管内治疗1例  

Endovascular treatment of chronic cerebral venous thrombosis complicated with dural arteriovenous fistula:a case report

作　　者：梅月昕 陈歆然[1] 陈红兵[1] 范玉华[1] 曾进胜[1] MEI Yuexin;CHEN Xinran;CHEN Hongbing;FAN Yuhua;ZENG Jinsheng(Department of Neurology,The First Affiliated Hospital,Sun Yat-Sen University,Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases,National Key Clinical Department and Key Discipline of Neurology,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院神经科,广东省重大神经疾病诊治研究重点实验室,国家临床重点专科,国家重点学科,广州510080

出　　处：《中国神经精神疾病杂志》2023年第6期362-366,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金青年科学基金项目(编号:81801059);广东省自然科学基金博士启动项目(编号:2017A030310523)。

摘　　要：报告1例颅内静脉慢性血栓形成合并硬脑膜动静脉瘘的诊治过程和转归。患者为49岁男性,以记忆力下降、情绪低落等症状起病,查体可见高级神经系统功能异常,初始磁共振见双侧基底节区异常信号,外院误诊为脑炎,予激素治疗后症状逐渐加重。后磁共振静脉成像及数字减影血管造影示颅内静脉血栓合并硬脑膜动静脉瘘,药物治疗1个月后临床症状及颅内病灶均加重;对颅内静脉血栓予血管内治疗后再通,硬脑膜动静脉瘘血流也发生转向。术后随访患者症状显著改善,原基底节区病变明显缩小。本文通过分析该病例特点,为类似病例的临床诊治提供参考。We report a case of chronic cerebral venous thrombosis complicated with dural arteriovenous fistula and analyze its diagnosis and treatment process and clinical outcomes.The patient was a 49-year-old man with the onset of memory loss and depression.Physical examination revealed abnormalities in advanced nervous system function.The initial magnetic resonance imaging showed abnormal signals in bilateral basal ganglia regions.The patient was misdiagnosed as having encephalitis,and his symptoms gradually worsened after corticosteroid treatment.The magnetic resonance venography and digital subtraction angiography showed intracranial venous thrombosis with dural arteriovenous fistula.The clinical symptoms and intracranial lesions gradually aggravated one month following treatment.After intravascular treatment of cerebral venous thrombosis,the occlusive venous sinus was recanalized and the blood flow of dural arteriovenous fistula was drained in the reverse direction.During postoperative follow-up,the symptoms were significantly improved and the lesions of basal ganglia regions were dramatically reduced.This article provides reference value for clinical diagnosis and treatment of similar cases by analyzing the characteristics of this case.

关 键 词：双侧基底节区病变 颅内静脉血栓形成 硬脑膜动静脉瘘 血管内治疗 球囊扩张 支架植入 

分 类 号：R743.9[医药卫生—神经病学与精神病学]