The Clinical Features Of Chinese Cerebral Venous Sinus Thrombosis

Object: To explore the risk factors, clinical features, imaging findings, treatment and outcome of cerebral venous sinus thrombosis.Method: we searched the databases for all articles existing (in all languages) for evidence relevant to cerebral venous sinus thrombosis, and medical records at Tongji Hospital, and then retrospectively analyzed the collected data of risk factors, clinical manifestations, imaging fingdings, laboratory tests, management and prognosis.Result:①A total of 1258 cases were obtained, male 497 cases and female 761 cases, aged 18-75 years old, the average age of all case series was less than 40 years old. The mean age of all case reports was 36.04±11.91 years old. The most mode of onset was acute The Common clinical symptoms and signs were headache, vomiting, seizures papilledema, paralysis of limbs, disturbance of consciousness. The most common risk factors included the puerperium, puerperal infection, drugs, blood diseases, pregnancy, miscarriage, autoimmune disease. No specific changes found in CSF. Treatment, included anticoagulation, thrombolysis, and symptomatic treatment, most with anticoagulation. Most patients had good prognosis.②In Department of Tongji Hospital, we obtained 16 cases of cerebral venous sinus thrombosis, male 9 cases and female 7 cases, aged from 20 to 57 years old, the mean age was 27 years old. The most mode of onset is acute. The initial symptoms were headache and seizures. The main clinical manifestations were headache, vomiting, seizures, disturbance of consciousness, papilledema, and limb paralysis. The risk factors included infection, hyperthyroidism, oral contraceptives, long-term use of clozapine, essential thrombocythemia, puerperium, pregnancy, lung cancer. The CSF was not specific. 16 cases underwent CT, and cerebral lesions founded, but the typical empty triangle sign, dense triangle sign were not common. 16 cases underwent MRI, and can be found incomplete or absent filling or delayed emptying of one or more sinuses. All patients underwent angiography (CTV, MRV, and DSA) examination, 14 patients with multiple sinus involvement, and 2 cases involving the left transverse sinus alone. They were administered antithrombotic therapy, lower and normalized the elevated intracranial pressure, and symptomatic treatment for seizures, headache, et al. All patients did not receive surgical treatment. More patients recovered. The NHISS of before and after treatment was statistical analyzed and the difference was significant (t =- 3.255, P <0.01). Up to 5 cases were followed up, and all patients reached full recovery at hen end of follow-up period.Conclusion:The clinical manifestations of Cerebral venous sinus thrombosis were complex and diverse. Diagnosis depended on imaging features. Most patients had risk factors. With promptly active treatment, many patients had better prognosis.