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《Chinese Journal of Clinical Medicine》 2006-02
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Analysis on the Early Diagnosis and Treatment of Cerebral Venous Sinus Thrombosis in 20 Cases

JIANG Mei DONG Qiang Department of Neurology,Pudong Gongli Hospital,Shanghai 200135;Department of Neurology,Huashan Hospital,Fudan University,Shang hai 200040  
Objective:To analyse the early diagnosis and treatment of cerebral venous sinus thrombosis (CVT). Methods:The onset age. possible etiology, clinical manifestations, imaging characteristics, changes of cerebrospinal fluid (CSF) and treatment in 20 patients (male 11 and female 9) with CVT were retrospectively analyzed. Results:The clinical cause of our cases was varied considerably. The CVT was most commonly seen in people of 20-40 years old, and the onset was acute in roughly 70% of cases. The first and most common symptoms included headache(85%) and vomit(60%), with or without focal deficits and/or seizures. Neuroimaging findings showed 40% Parenchymal focal infarction and cerebral venous and sinus occlusions. As for CSF examination, pressure increased remarkably(83. 3%), with WBC and protein normal or increased slightly. Based on dehydration and etiologic treatment, anticoagulation, local thrombolysis treatment were utilized in 15 patients,5 severe cases had poor outcomes. Conclusion: Headache, vomit with or without focal deficits and /or seizures as initial presentation should raise the suspicion of CVT, Neuroimaging examination (combination of MRI and MRV) make diagnosis for certain. We might have to examine and control the underlying disease thoroughly. Early administration of anticoagulation is recommended as first-line treatment of CVT. Where this fails, and in severe cases, endovascular approaches, involving direct infusion of thrombolytic agents, have been used.
【CateGory Index】: R743.3
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