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目的探讨脑静脉窦血栓形成(CVST)的临床的特点、诊断和治疗。方法回顾性分析武汉协和医院2007年1月~2010年11月24例CVST患者的发病年龄、起病形式、主要症状、实验室检查、影像学特征以及治疗情况。结果 CVST临床表现以颅内高压症状多见如头痛、恶心、呕吐(约占71%),约67%患者存在局灶性神经系统损害的表现。CVST最常累及横窦和乙状窦,其次是上矢状窦。磁共振静脉造影(MRV)的影像质量高,能清晰显示病灶。9例患者接受抗凝治疗症状明显缓解,均未发生出血。死亡2例(约占8.3%)。结论 CVST是一种可能致命的神经系统急症,MRV是CVST较好的诊断方法,抗凝治疗安全有效。
Objective To investigate the clinical features, diagnosis and treatment of cerebral venous sinus thrombosis (CVST). Methods A retrospective analysis of the clinical data of 24 patients with CVST from January 2007 to November 2010 in Wuhan Union Hospital from January 2007 to November 2010 was used to analyze the age, onset form, main symptoms, laboratory findings, imaging characteristics and treatment of 24 CVST patients. Results The clinical manifestations of CVST were more common in patients with intracranial hypertension such as headache, nausea and vomiting (about 71%) and focal neurological damage in about 67% of patients. CVST most commonly involves the transverse sinus and sigmoid sinus, followed by the superior sagittal sinus. Magnetic Resonance Venography (MRV) is a high-quality image that clearly shows the lesion. Nine patients underwent anticoagulant therapy and their symptoms were relieved without any bleeding. 2 died (about 8.3%). Conclusion CVST is a potentially fatal neurological emergency. MRV is a better diagnostic method for CVST. Anticoagulant therapy is safe and effective.