Clinical And Imaging Analysis Of Cerebral Venous Sinus Thrombosis

Objective: To provide the basis for clinical diagnosis and treatment by analyzing the clinical and imaging features of cerebral venous sinus thrombosis.Methods: Collecting the clinical data of 57 patients with CVST in our hospital from October 2014 to July 2016,this paper used descriptive statistical analysis method combined with relevant literature to analyze the above data.Results: There were 57 patients in this group,including 18 males and 39 females,male and female ratio 1: 2.17,mean age(39.83 ± 18.31)years,age range 14-75 years.20-50 years of age accounted for 60% of all patients with CVST.Thirty-nine patients(68%)of the 57 patients found one or more risk factors,and the remaining 18(32%)had failed to detect possible risk factors.Common risk factors include infection,puerperal,thrombotic tendencies(hereditary or acquired),oral contraceptives,and malignancies.In this group of patients with acute onset(<7d)in 19 cases(33%),subacute onset(8-30d)in 21 cases(37%),chronic onset(30d or more)in 17 cases(30%).The most common clinical manifestations of this group of patients was headache(96.49%),other clinical manifestations include nausea,vomiting,decreased vision,focal neurological dysfunction and seizures.The positive rate of CT scan was 38.9%,MRI scan(T1WI,T2 WI,FLAIR)found abnormalities in 46 cases(80.7%),MRV examination showed abnormalities in 52 cases(91.2%),8 cases underwent DSA examination,showing one or more stenosis,filling defect or no development.Common parts of the thrombosis were transverse sinus,superior sagittal sinus,sigmoid sinus..Fifty-one patients underwent lumbar puncture and 36 patients(70.59%)with elevated intracranial pressure and mean pressure of cerebrospinal fluid was(237.0 ± 56.8)mm H2 O.All cases were treated with anticoagulant therapy,combined with reducing intracranial pressure and balancing electrolyte.Forty-nine patients(86%)were discharged after treament,with no neurological deficits,and5 cases(8.77%)had a slight neurological deficit,but did not affect life.Conclusion: 1.CVST often occurs in the young and middle age,the incidence of women is higher than men,the form of onset mostly acute or subacute;CVST has many causes,most patients have one or more risk factors;2.CVST clinical symptoms are complex and lack of specificity,headache is most common symptom and the most important clinical manifestations;3.MRI combined with MRV is the best method of diagnosis of CVST,if necessary,taking DSA examination can improve the accuracy of diagnosis.In addition,lumbar puncture,D-Dimer can assist diagnosis;4.Anticoagulation therapy should be implemented as soon as possible,if the anticoagulant is ineffective,the patients can be treated with endovascular therapy..