摘要
目的:研究围生期颅内静脉窦血栓形成的临床和影像学特征。方法:对13例围生期颅内静脉窦血栓形成患者的临床及影像学特点进行分析。结果与结论:13例均有头痛和视乳头水肿,发热8例,呕吐7例,肢体运动障碍7例,肢体偏瘫5例。6例行头颅CT检查,均发现脑实质内多发低密度影,但均未能显示CVST的直接征象---空三角征。13例行MRI,能明确静脉窦内有异常信号影6例,此6例中增强扫描后呈空三角征5例(此5例可确诊CVST);13例均可见较有诊断价值的静脉性脑梗死征象。13例行磁共振静脉成像(magnetic resonance venography,MRV),均能显示CVST病灶的静脉窦狭窄、闭塞或者充盈缺损。所有病例均予低分子肝素抗凝及脱水等对症治疗,全部治愈。对于围生期出现颅内压增高表现伴或不伴肢体运动障碍、肢体瘫痪等症状的患者首先应想到CVST,及时行MRI及MRV以作出诊断,给予低分子量肝素等治疗,可以提高治愈率。
Objective： To study the clinical and imaging features of perinatal cerebral venous sinus thrombosis （CVST）. Methods： The clinical and imaging features were analyzed in 13 cases of perinatal CYST. Results and Conclusion： 13 patients had headache and edema of discus opticus, 8 had fever, 7 had vomiting, 7 had limb cinesipathy and 5 had limb hemiparalysis. Brain CT was performed in 6 cases and showed multiple low density shadow in cerebral parenchyma, but no direct sign of CVST empty triangle. MRI was performed in 13 patients, in which 6 cases of abnormal wink in venous sinus after enhancement scanning, 5 cases of empty trangle and 13 cases of vein cerebral infarction. MRV of 13 cases showed sinus venosus narrow, occlusion or filling defect. All patients were cured by anticoagnlation （ low molecular weight heparin） , dehydration and symptomatic treatment. Perinatal CVST should be thought of in the patients with the appearance of intracranial pressure increasing （ with or without limb cinesipathy, limb bemiparalysis）. MRI combined with MRV is the primary diagnosing method for perinatal CVST. Early identification with MRI and MRV and treatment with low molecular weight heparin may improve the cure rate.
出处
《新医学》
北大核心
2008年第9期583-585,F0003,共4页
Journal of New Medicine
关键词
颅内静脉窦血栓形成
围生期
磁共振
磁共振静脉成像
低分子量肝素
临床表现
Cerebral venous sinus thrombosis Pcrinatal period Magnetic resonance Magnetic resonance venography Low molecular weight heparin Clinical manifestation
