Clinical Analysis Of 112 Cases Of Cerebral Venous Sinus Thrombosis

Objective To analyze the etiology,clinical manifestations,laboratory and imaging examinations,and treatment options of cerebral venous sinus thrombosis（CVST）at the XXX,in order to improve the understanding of CVST and the clinical diagnosis and treatment level of this disease.Methods We collected and retrospectively analyzed the case data of inpatients with CVST admitted to the Neurology Department of the XXX from October 2016 to October 2021.The data included general information,clinical symptoms and signs,laboratory and imaging data.According to the etiology,CVST was divided into the infection group and the non-infection group,and the data of the two groups were compared and analyzed.Meanwhile,according to the range of involvement of the cerebral venous sinus,CVST was divided into single sinus involvement and multiple sinus involvement,and the clinical features of the two groups were compared.Results We summarized the clinical data of 112 cases of CVST and found that:（1） CVST is more common between 21 and 40 years old,with an average onset age of 34 years.（2）The onset of CVST is mostly subacute,and chronic onset is rare.The most common clinical manifestations are headache accompanied by dizziness,nausea,and vomiting,and the headache is mostly continuous and variable in location.（3）After admission,111 cases（99.11%）of CVST patients had elevated D-dimer levels,while only one case was normal.Among the 101 patients who underwent lumbar puncture,97 cases（96.04%）had a cerebrospinal fluid pressure of≥180mm H₂O,and only three cases had a pressure of<80 mm H₂O.（4）Most CVST cases involve multiple sinus（80.36%）,with the transverse sinus and sigmoid sinus being the most commonly affected sites.（5）Among 112 CVST patients,63 cases were treated with low molecular weight heparin calcium and normalized anticoagulation.After treatment,the D-dimer level was significantly reduced compared to admission（P<0.001）.Summary of different etiologies:（1）The difference in gender between the infected and non-infected groups was statistically significant（P<0.05）.（2）The etiology of CVST is diverse,with non-infectious causes being more common.Among the non-infectious causes,hemodynamic abnormalities and hypercoagulable states are the most common.（3）In terms of clinical symptoms,fever and mental abnormalities were more common in the infection group（P<0.05）.（4）The infection group had higher levels of hemoglobin and mean red blood cell hemoglobin concentration than the non-infection group,but lower red blood cell volume distribution width and D-dimer levels（P<0.05）.（5）Both groups were mainly affected by multiple venous sinuses,but two affected sites were most common in the infection group.According to the different ranges of involvement,it can be concluded that:（1）There is no statistically significant difference in gender and age of onset between single and multiple venous sinus thrombosis.（2）Nausea,vomiting,and seizure are common in patients with multiple venous sinus thrombosis.（3）The number of patients with secondary brain parenchymal damage in multiple venous sinus thrombosis is more than that in single venous sinus thrombosis,but the difference is not statistically significant（P>0.05）.Conclusions1.CVST mainly presents with subacute onset,diverse etiologies,with non-infectious factors being more common,and among them,blood hypercoagulability and hemodynamic abnormalities are the most common.Patients are mostly between 21 and 40 years old,and women are more common.Clinical features are characterized by intracranial hypertension and movement disorders.2.In the non-infection group,the hemoglobin and mean red blood cell hemoglobin concentration are lower than those in the infection group,but the red blood cell volume distribution width and D-dimer are higher than those in the infection group.3.The most commonly affected sites of CVST are the transverse sinus and sigmoid sinus,followed by the superior sagittal sinus.The vast majority of CVST involves multiple venous sinuses,and patients are more likely to experience nausea,vomiting,and seizures than those with single venous sinus thrombosis.