Clinical And Image Analysis Of Cerebral Venous Thrombosis In 45 Cases

Backgrounds and Objectives:Cerebral venous thrombosis (CVT) is a rare cerebrovascular disease. It was first reported and recorded detailly in France in 1825. The risk facters of CVT are relatively complicated. Pregnancy and puerperium, oral contraceptives, dehydration, high blood coagulation state, intravascular vegetations and facial infection are common risk factors. However, causes cannot be found in about 30 percent of cases. The clinical manifestations of CVT also have no specificity. Headache is the most common symptom. There are many other symptoms such as papillary edema, focal neurologic deficits, seizures, and so on. Due to this variability in clinical manifestations, and the rarity of the condition, CVT can be difficult to diagnose. With the development of modern imaging techniques such as the CTV(Computerized Tomography(CT)-venography), MRV(Magnetic Resonance venography) and DSA(Digital subtraction angiography), the early diagnosis rate is elevated. However, the relevant epidemiological data of the disease is still insufficient, and the understanding of the disease is still relatively limited. Through our clinical data collection and analysis, we aim to improve the understanding of the disease and the effect of treatment.Methods:We collected 45 cases treated by Shandong Provincial Hospital. Then age, sex, risk factors, clinical manifestations, imaging features, treatment and prognosis were respectively statisticed and retrospective analyzed..Results:This group of 45 patients was mostly young and middle-aged, in which only 6.7% patients were over 50 years of age. Women were affected 1.5 times more often than men. The risk factors of CVT patients were variable. Pregnancy and puerperium were the most common risk factors in the young and middle-aged women(50.0%). Other risk factors included high blood coagulation state, tumor and so on. The vast majority of patients suffered from a headache as the first symptom(88.9%). Other common signs and symptoms included nausea, vomiting, fever, movement disorders, seizures, and so on. MRI/MRV played an important role for the diagnosis. Lateral sinus and superior sagittal sinus were the most common locations of the disease. Approximately 30% of patients have an intracerebral hemorrhage, which can range from a small juxtacortical hemorrhage to large space-occupying lesions. The primary therapy for CVT is anticoagulation with heparin and symptomatic treatment. The treating effect could be better with a positive and effective etiological treatment and symptomatic treatment.Conclusion and significance:Cerebral venous thrombosis is an important cause of stroke in the young. Patients can present with a range of signs and symptoms. Due to this variability in clinical manifestations, and the rarity of the condition, CVT can be difficult to diagnose. The final diagnosis depended on neuroimaging techniques. MRI/MRV has proved to have the highest sensitivity and specificity in establishing a diagnosis. The treating effect could be better with a positive and effective etiological treatment and symptomatic treatment.