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目的加深对脑静脉血栓形成的认识、提高诊疗水平。方法回顾性分析南方医科大学附属珠江医院22例脑静脉血栓形成病例的年龄、病因、临床症状、实验室及影像学资料、治疗方法。结果 22例患者中,男:女比例1:1;年龄自16岁到61岁;临床症状以头痛最为常见,可伴发呕吐、视乳头水肿、癫痫、肢体偏瘫、语言障碍、动眼神经麻痹等局灶性神经功能损害及意识障碍;影像学检查可采用MRV/DSA/CTV,血栓累及侧窦、上矢状窦最常见,且常合并累及多个静脉/静脉窦;经抗凝、降颅压、对症等治疗,有20例症状缓解,复查提示原来血栓形成的静脉/静脉窦不同程度的再通;2例病情加重,其中1例死亡。结论颅内静脉窦血栓形成病因多种,发病形式多样,临床表现无特异性,随着磁共振MRV、CTA、DSA的应用,脑静脉血栓形成的诊断已不是难题,且治疗效果较好;另外神经介入治疗值得关注与期待。
Objective To deepen the understanding of cerebral venous thrombosis and improve the diagnosis and treatment. Methods The age, etiology, clinical symptoms, laboratory and imaging data of 22 cases of cerebral venous thrombosis in Zhujiang Hospital Affiliated to Southern Medical University were retrospectively analyzed. Results Of the 22 patients, the male-to-female ratio was 1: 1 and the age ranged from 16 to 61. The most common clinical symptom was headache, which was associated with vomiting, papilledema, epilepsy, limb paralysis, speech impairment, oculomotor nerve palsy And other focal neurological impairment and disturbance of consciousness; MRV / DSA / CTV can be used for imaging examination, thrombosis involving the lateral sinuses, the superior sagittal sinus is the most common, and often involving multiple venous / sinus; by anticoagulation, Intracranial pressure, symptomatic treatment, there are 20 cases of remission, review showed that the original thrombosis of venous / sinus recanalization to varying degrees; 2 cases aggravated, including 1 case of death. Conclusions There are many causes of intracranial venous sinus thrombosis with various forms and clinical manifestations. With the application of magnetic resonance MRV, CTA and DSA, the diagnosis of cerebral venous thrombosis is no longer a problem and the treatment effect is good. In addition, Nerve intervention is worth attention and expectation.