Clinical Analysis Of Cerebral Venous Sinus Thrombosis In 38 Cases

ObjectiveTo study the risk factors,the clinical features,cerebrospinal fluid,imaging feautures, treatment and prognosis of cerebral venous sinus thrombosis, in order to improve the diagnosis and treatment of this disease.MethodsRetrospective analysis of 38 patients with clinical data of patients with CVST, and telephone follow-up to compare the brain in real terms in the same time, the normal brain parenchyma involved with the clinical signs and symptoms in patients with CVST different areas, and to further compare the brain substance involved or not, the impact on prognosis.ResultsOnset age of 16-57 years, male to female ratio 1.4:1; 63% of patients can find the relevant risk factors, including changes to more common infections and estrogen; the most common clinical presentations were headache (92.1%), followed by nausea and vomiting (65.8%), epilepsy (42.4%), paresis (28.9%), there is substantial involvement of secondary brain clinical symptoms CVST heavier, more susceptible to epilepsy (61.9% vs17.6%), hemiplegia (52.3% vsll.8%), mental disturbance of consciousness (19.0% vs0%). Check the pressure most cases lumbar puncture was significantly higher (85.7%), cerebrospinal fluid protein and cell count was normal or slightly elevated. 14.8% of cases, cerebral venous sinus CT follow-shaped high density area,56.8% of the patients brain MRI scan shows that part of the venous signal or flow void signal abnormalities disappeared, the Brain and MRV examination of all patients (33 cases) visible lesions develop bad sinus or imaging. The anticoagulant, anti-platelet aggregation, decreasing intracranial pressure and other symptomatic treatment and due to a small number of interventional treatment, most patients (92.1%) got better, a small number of cases of disease progression (7.8%). Obtain follow-up data of 36 patients, there is substantial involvement of secondary brain in 20 cases, follow-up, mRS score at 0-2 between 90.0% and no secondary brain substance involved in 16 cases and follow-up, mRS score between 0-2 hours in 93.8% efficiency difference between the two groups was not statistically significant (P= 0.58).ConclusionFor acute or subacute onset, in order to highlight the performance of intracranial hypertension, without apparent signs of central nervous system infections in young patients, the possibility of CVST should be considered, especially when the brain MRI showed no abnormal signals by vascular distribution, sinus blank signal disappears or abnormal, the more highly suggestive of CVST. Real existence of secondary brain involvement in patients with severe clinical features of CVST are more vulnerable to seizures, paralysis, mental disturbance of consciousness, but as active treatment in time, its long-term prognosis with no real involvement of secondary brain in patients with CVST compared with no significant difference.