颅内静脉系统血栓形成的临床和影像学分析

摘要

Objective To investigate the clinical and imaging manifestations of intracranial venous thrombosis,and to provide evidence for clinical diagnosis and treatment of the disease.Methods Seventy-one cases of intracranial veins and venous si-nus thrombosis patients in our hospital were selected in this study.Demographic data,clinical symptoms and signs,imaging mani-festations,biochemical laboratory tests,etiology,and treatment and prognosis were statistically analyzed.Results Among the 7 1 patients,intracranial hypertension symptoms(headache,nausea,vomiting),epilepsy,blurred vision or vision loss were the most common clinical manifestations.D-dimer was elevated in 67(94.4%)cases.Transverse sinus thrombosis in 34(47.9%)cases,sig-moid sinus thrombosis in 25(35.2%)cases,superior sagittal sinus thrombosis in 44(62%)cases,deep cerebral venous thrombosis (straight sinus or Galen vein)in 9(12.7%)cases,two or more venous sinus thrombosis in 52(73.2%)cases.Conclusion The clinical manifestation of CVST is lack of specificity.Physicians need to consider the possibility of CVST in patients with headache and negative head CT scan,especially puerperal patients or with autoimmune diseases.%目的：探讨颅内静脉系统血栓形成的临床和影像学表现以及治疗和预后，为该病的临床诊断和治疗提供依据。方法选取我院就诊的颅内静脉和静脉窦血栓形成患者71例，收集人口学资料、临床症状和体征、影像学表现、生化等实验室检查、病因，以及治疗方案和预后，并进行统计学分析。结果71例患者中，常见的临床表现为颅高压症状(头痛、恶心、呕吐)、癫痫、视物模糊或视力下降等。D-二聚体升高67例(94.4%)。横窦血栓形成34例(47.9%)，乙状窦血栓形成25例(35.2%)，上矢状窦血栓形成44例(62.0%)，深部脑静脉血栓形成(直窦或 Galen静脉)9例(12.7%)，同时累及2个或以上静脉窦者52例(73.2%)。结论 CVST 的临床表现缺乏特异性，临床上对于头部 CT 未见明显异常的不明原因的头痛患者、产褥期或口服避孕药或合并自身免疫性疾病的女性头痛患者，需考虑CVST可能性，并积极行影像学检查，早期识别，早期诊断。