脑静脉窦血栓形成26例临床分析.docx

脑静脉窦血栓形成26例临床分析[摘要]目的：探讨脑静脉窦血栓形成（CVST）的临床表现、影像学特征及预后。方法：回顾性分析26例CVST患者的临床表现、实验室资料、影像学特征、治疗经过及预后。结果：26例中早期表现以头痛为主20例。脑脊液压力增高者24例脑脊液蛋白和白细胞数正常或轻度升高；典型病例颅脑CT可见到血栓局部条索状高密度影或伴有出血和水肿。MRI平扫可见病变静脉窦异常血栓信号。MRV和DSA可见病变静脉窦显影不良或不显影。经降颅压、抗凝及对症治疗部分病例行溶栓治疗18例好转出院(69.2%)；痊愈3例(11.54%)DSA显示静脉窦完全再通；死亡1例(3.85%)；另有4例患者因病情危重家属放弃治疗自动出院总有效率80.8%。结论：CVST临床表现缺乏特异性确诊有赖于影像学检查抗凝溶栓是主要的治疗方法。[关键词]脑静脉窦血栓形成；临床表现；影像学；抗凝[中图分类号]R743.32[文献标识码]A[文章编号]1673-7210（2008）06（c）-060-02Clinicalanalysisof26patientswithcerebralvenoussinusthrombosisCHENYong-qingLIPeng-longYANGXiao-yu（DepartmentofLaiyangCentralHospitalYantai265200China）[Abstract]Objective:Toexploretheclinicalfeatureimagingfeatureandprognosisofcerebralvenoussinusthrombosis（CVST）.Methods:Retrospectiveanalysisontheclinicalfeatureslaboratorydataneuroimagingchangestreatmentandprognosisin26CVSTpatients.Results:20outofall26patientswerepresentedheadache.TheintracranialpressureincreasedobviouslyinCVSTpatientswhiletheproteinconcentrationandwhitebloodcellcountinCSFwerenormalorincreasedslightly.HighdensityliketrabswasfoundbyCTscanintypicalcaseandsomewithedemaorhemorrhage.Abnormalsignalsofthrombuswerealwaysfoundonmagneticresonanceimaging(MRI)ofbrain.Poorvisualizationornonvisualizationofvenoussinuswerefoundonmagneticresonancevenography(MRV)anddigitalsubtractionangiography(DSA).18of26patientsimproved3of26patientsrecoveredafterthetreatmentwithanticoagulantdecreasingtheintracranialpressureothersymptomatictreatmentandsomethrombolysis.Thetotaleffectiveratioaccountedfor80.8%.Conclusion:Cerebralvenoussinusthrombosishasnospecificclinicalfeature.Neuroimagingexaminationactsasakeyroleonthefinaldiagnosis.Anticoagulationandthrombolysisaresafeandeffectivetherapy.[Keywords]Cerebralvenoussinusthrombosis;Clinicalfeature;Neuroimaging;Antic