The Clinical Analysis Of 99 Cases Of Cerebral Venous And Sinus Thrombosis

Objective: In-depth discussion of intracranial venous system thrombosis in patients with risk factors,clinical features,radiological features,laboratory examination and treatment and prognosis,aimed at improving the understanding of CVST,CVST patients to get early diagnosis and proper treatment,improve the prognosis.Methods: A retrospective analysis of the imaging and clinical characteristics of the hospital medical records of 99 patients with CVST diagnosis detailed records of the patient's demographic data(gender,age),the form of onset,risk factors,first symptoms,clinical manifestations,imaging findings,laboratory examination,treatment and prognosis,and clinical data on the comprehensive analysis of the system.Results:(1)Male and female ratio of 1:1.36;(2)In patients with onset age between 13 to 82 years old,the average age was 37.59 + /-15.73 years old,20 to 49 years old,71 cases(71.72%);(3)45 cases(45.46%)of acute onset,44 cases of subacute onset(44.44%),10 cases(10.10%),chronic onset;(4)Cranial pressure symptoms(headache,nausea,vomiting,papillary edema)in71 cases(71.72%).Nerve function defect symptoms(symptoms such as hemiplegia,aphasia,hemianopsia)32 cases(32.32%).Encephalopathy symptoms(consciousness,memory loss,seizures,and even coma)37 cases(37.37%);(5)79(79.80%)patients have multiple venous sinus involvement(2)or more at the same time,the transverse sinus,68 cases(68.69%),sigmoid sinus,57 case(57.58%),superior sagittal sinus,56 cases(56.57%);(6)99 routine head CT examination,brain infarction,3 cases(3.03%),parenchymal hemorrhage in 10 cases(10.10%),7cases of subarachnoid hemorrhage(7.07%),parenchymal hemorrhage associated with infarction in 2 cases(2.02%),brain swelling or hydrocephalus in 2 cases(2.02%).93 routine MRI of head,90 head MRV examination,routine MRI in head and(or)found in the head MRV examination abnormal,MRI signal mainly for different periods of thrombosis and parenchymal lesions,MRV mainly for venous sinus enhancement or its lumen in irregular filling defect;7 routine DSA examination,main performance for lumen thinner even in sinus occlusion,uneven tube cavity signals;3 regular checks on the 3 d VISTA,suggesting the corresponding parts of venous sinus thrombosis;(7)Waist wear inspectors in 87 cases,68 cases(78.16%),the pressure is higher thannormal,elevated cerebrospinal fluid leukocyte 31 cases(35.63%),elevated in 36 cases(41.38%),red blood cells is 39 cases(44.83%),sugar,chloride were normal;50 cases examined homocysteine levels,20 cases(40%)increased;55 patients tested the levels of estrogen,10 cases(18.18%),and all are men;66 patients examined D-dimer level,60 cases(90.91%)increased;(8)This study of 99 cases of patients,hospital cure 51 cases,effective 37 cases,11 cases failed.Conclusion:(1)Need to pay attention to the neglected CVST clinical risk factors: high homocysteine levels,and male patients of oestrogen,lower cranial pressure syndrome.(2)MRI sequences of VISTA is diagnosing CVST better imaging examination method.(3)D-dimer detection of CVST diagnosis is of important value.(4)The treatment of anticoagulation should be taken,and the causes of CVST and support treatment is given priority to the comprehensive treatment of symptomatic,if his condition deteriorated,can take endovascular interventional treatment.