Clinical Analysis Of105Cases With Cerebral Venous And Sinus Thrombosis

Objective:This study aimed to investigate the clinical characteristics of105cases with cerebral venous and sinus thrombosis(CVST).Methods:105cases were included if they have a confirmed diagnosis of CVST based on radiological diagnosis were retrospectively analyzed. Among them,57cases were male and the other48were female. Analysis the age, risk factors, symptoms, laboratory tests, image findings, management and outcome of these CVST patients.Results:①The CVST often occurred in patient with21～50years old, mean age range of38.35±15.76years old, the age of onset between males and females had no significant difference(p>0.05);②Most cases had acute course;③Headache was the most common symptom, followed by vomiting, seizures, a focal neurologic deficit, and coma may occurred in severe cases;④For male patients, it is more often related to thrombophilia(35.42%) and infections(26.32%), while for women, it is more often related to puerperium(20.83%) and anemia(20.83%);⑤the straight sinus was thrombosed in93cases, follow up were sigmoid sinus in57patients, the superior sagittal sinus in52patients. In all, all patient had evidence of cerebral venous and sinus thrombosis or occlusion by computed tomography/magnetic resonance imaging, focal infarction can be tested in15patients, hemorrhagic infarction or hematoma occurred in29patients,20patients seen prominent edema of the parenchyma,19patients with subarachnoid hemorrhage;⑥cerebrospinal fluid pressure increased markedly(63/72, 87.50%), white blood cell and protein content had no specificity;⑦After treatment of anticoagulation, dehydration, etiological treatment and supportive treatment,92of the105patients had a good outcome,11patients had a poor outcome, progressively deteriorated, discharged, or death.⑧Univariate identified predictors of poor hospital prognosis in the acute phase of CVST including altered consciousness(OR6.16,95%CI1.66-22.82, p<0.05), initial measured cerebrospinal fluid pressure>400mmH2O(OR5.31,95%CI1.14-24.72, p<0.05), prominent edema of the parenchyma(OR6.69,95%CI1.79-24.93, p<0.05).Conclusions:The age of occurrence of cerebral venous and sinus thrombosis was younger, the clinical manifestation was nonspecific. So we should highly suspicious of young patients who overcome by headache, vomiting, with or without neurological deficits and seizures to be CVST, MRI/MRV should be undertaken as soon as possible to definite the diagnosis. Several risk factors can cause or predispose patients to CVST, still some patients didn’t find an exactly cause at present, there’s a significant difference between the risk factors of male and females patients. Most of the patients underwent anticoagulation and comprehensive therapy, the prognosis is favorable. Severe cases may experience a quick onset and change course, with high rate of death and poor prognosis. Altered consciousness, initial measured cerebrospinal fluid pressure>400mmH2O, prominent edema of the parenchyma may affected the prognosis of CVST.