Intracranial Venous Sinus Thrombosis Patients With Clinical Analysis And Follow-up

Objective: To analyze IVST patients with clinical risk factors,results of laboratory examinations, the form of onset, clinicalmanifestations, treatment options and prognosis, provide the basis for thediagnosis and treatment of patients with clinical work IVST programdevelopment and the prevention of recurrence provide guidance.Methods: From October2004to December2012，We retrospectivelycollected120patients diagnosed with intracranial venous sinus thrombosisatthe First Bethune-hospital of Jilin University。To record the patient’s gender,age, length of stay, ancillary test results, imaging findings, clinicalmanifestations, treatment and prognosis of follow-up data were statisticallyanalyzed. Measurement data using t-test; inspection level difference wasstatistically significant at P <0.05.Rusult:(1)120patients, the male to female ratio is1:1.5. Male peakage is30-39and the most common risk factors was infection of the headand face, followed by dehydration; the female peak age is20-29,and themost common risk factors is puerperal, followed by oral contraceptives,estrogen and so on.(2) Headache (with nausea and vomiting in40cases,59cases), convulsions42cases,19cases of disturbance of consciousness,30cases with limb-dysfunction,5cases of speech disorders,6cases oflimb sensory disturbances,2cases of oculomotor nerve paralysis,14cases of blurred vision,1case with urinary disorders.(3)84patientsaccepted a lumbar puncture, while40cases reviewed the lumbarpuncture after receiving anticoagulant therapy。40patients before and after lumbar puncture pressure reduced40mm2O,with statisticallysignificant difference (P <0.05);(4) The sagittal sinus is most commonlyaffected (75%); followed by transverse sinus (72.5%), sigmoid sinus,straight sinus (31cases), superficial veins alone (n=7);(5) Follow-up68patients, in which26cases with good-coming,19cases with headache,11died,1cases dizziness,1cases language stupid，1case both lowerlimbs-dysfunction,1case with the unilateral limb-dysfunction,3cases ofvisual impairment，1with double shadow,6cases (1casewith lowerextremity thrombosis) recurrence.11patients were followed up videodisplay sinus were not completely open, but the rich collateral circulation;and1case evolution of dural arteriovenous fistula.Conclusions:1. Sagittal sinus is most commonly affected sinus, followed by thetransverse sinus, sigmoid sinus, straight sinus; on the follow-up image,the recanalization rate of straight sinus was the highest, followed by thetransverse sinus, superior sagittal sinus.2. The clinical manifestations of IVST have non-specific, whichshould be diagnosised with MRV、CTV and DSA3. The anticoagulant therapy is effective to IVST,and the therapycan significantlyreduce intracranial pressure; the severe patient of IVSTmaybe benified from the intravascular thrombolysis and mechanicalthrombectomy and other interverternal treatment.4. Most of IVST patients are with good prognosis.The establishmentof the intracranial and extracranial venous collateral circulation and thesinus recanalization and are the key to a good prognosis factors.