Clinical Analysis Of 80 Cases Of Cerebral Venous Sinus Thrombosis

Objective: To discuss the causes, high risk factors, clinical features and treatment effect of cerebral venous sinus thrombosis(CVST).Methods: Analyze retrospectively the average age and types of onset, causes and high risk factors, clinical features, imaging characteristics, treatment effect and prognosis of 80 cases with CVST admitted in our hospital from Jan.2008 to Dec.2014.Results: A total of 80 patients were diagnosed with CVST, including 36 males and 44 females, male to female = 1: 1. 22. CVST often occurred in young people and middleaged, which was from 12-77 years old and the average age was 39.79 years old. 38cases(47.5%) appeared with acute onset(< 1 week), 31 cases(38.75%) appeared with subacute onset(1 week- 1 month) and 11 cases(13.75%) appeared with chronic onset(> 1 month). 17 cases( 16.25%) were associated with infection, including viral encephalitis, head and facial infection, mastoiditis, otitis media and sinusitis; 14 cases(17.5%)were associated with pregnancy, 6 cases(7.5%)were associated with oral contraceptive. Other rare causes included cancer surgery, iron deficiency anemia,intracranial hypotension syndrome, rheumatic heart disease, mitral stenosis with atrial fibrillation, posthepatitic cirrhosis, hypothyroidism complicated with hyperthyroidism surgery. 33 patients(41.25%) were found with unknown etiology. Headache was the most common symptom and first symptom and was seen in 83.75% patients. Other common symptoms included nausea, vomiting, papilledema, diplopia, movement disorders with eyes, seizures, unconsciousness, paralysis and sensory disorders.Transverse sinuses and sigmoid sinuses ware most commonly involved. 40.0%patients involved only a single venous sinus and the rest 60.0% involved multiple sinuses. 60.71% patients appeared with increased intracranial pressure with 190-430 mm H20 and the average intracranial pressure was 258.48 mm H20. Direct signs were15% and indirect signs were 21.25% with brain CT. Positive rate with brain MRI /MRV was 100%. 72 cases received coagulation therapy with low molecular weight heparin, the effective rate was 85.0%, and the recurrence rate was 1.25%.Conclusions: CVST often occurred in young people and middle-aged with various types of onset and complex causes. Headache was the most common symptom and first symptom, other clinical symptoms varied and the lacked of specificity. Clinical symptoms combined with brain MRI/MRV can diagnosis definitely. Anticoagulation effect was obvious and the prognosis was good.