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context: Cerebral venous sinus thrombosis (CVST) previously believed to be an uncommon cerebrovascular event, accounting for0.5–1% of cases of stroke, affecting 1.32/100,000 person/year. CVST is a disease of young adults (<50 years old) predominantlyand is diagnosed based on clinical suspicion with confirmatory neuroimaging.Aims: This study aims to prospectively evaluate the Hounsfield unit (H.U) value of cerebral venous sinus on non-contrastcomputerized tomography (NCCT) scan and to assess its predictive value in diagnosing cerebral venous thrombosis and toevaluate whether standardizing venous sinus H.U value measurements to those of the corresponding internal cerebral arterywould improve diagnostic accuracy.Materials and Methods: In our study, a total of 80 clinically suspected case of CVST were included and NCCT head scan was donethen confirmed by M.R. venography (gold standard). Of 80 cases, a total of 38 cases were diagnosed as CVST on M.R. venographywhich was considered as Group B and rest 42 cases were normal on M.R. venography which was considered as Group A.Statistical Analysis: Average HU and H:H ratio were compared using two-tailed t-test, and linear regression analysis wasused to assess correlation between hematocrit (HCT) and HU.Results: Linear regression analysis showed positive correlation between HCT with computed tomography attenuation (HU)among both the groups (P < 0.005). H:H ratio (HU/HCT) for cutoff point of 1.645 had sensitivity of 71.1%, 97.6% specificity,and 96.4% PPV. A cutoff value of 1.335 for standardized measurement with internal carotid arteries (ICA) had 71.1% sensitivity,81% specificity, and 77.1% PPV.Conclusion: We conclude that average HU, H:H ratio, and standardized with ICA were the best predictor for sinus thrombosis.
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Objective To explore the characteristics of diagnosis and treatment of Behset's disease (BD) with meningeal thickening and to improve doctors" awareness of such diseases.Methods We reported a missed diagnosis of a patient with BD complicated with diffuse meningeal thickening,and reviewed the related literature.Results A 25-year-old young man,manifested mainly as recurrent headache,fever,recurrent oral ulcer,erythema skin nodules and folliculitis,and his cranial radiology revealed diffuse meningeal thickening and intracranial venous sinus thrombosis.We diagnosed him as neuropathy associated with BD.After the treatment with steroids,cyclophosphamide,infliximab and anti-coagulants,his symptoms improved rapidly.Conclusion In clinical,BD complicated with meningeal thickening is rare,which is easily misdiagnosed or miss-diagnosed.For the patients with unexplained meningeal thickening,the symptoms of BD,such as recurrent oral or genital ulcers,ophthalmitis and skin lesions,should be acquired in detail.In addition to steroids and immunosuppressive agents,anti tumor necrosis factor (TNF)-alpha can also be used in the treatment of BD with meningeal thickening.
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Intracranial venous sinus thrombosis is a special type of cerebral vascular disease. It usually originates from the later period of wasting disease, brain trauma, puerperium, blood disease, heart disease, eye/nasal/facial infection, meningitis and septicemia. It occurs in different age and sex. Infants, young children, frail elderly people, postpartum women, chronic disease patients are prone to be affected.Because of lacking of typical clinical manifestations, the clinical diagnosis and treatment of this disease is difficult and easily leading to misdiagnosis and mistreatment, which affects the prognosis of the patients.Because of lacking of standardized diagnosis and treatment strategy, different methods are needed. According to the proceeding reports, we reviewed the current progress of the diagnosis and treatment of intracranial venous sinus thrombosis.
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Objective To explore the anticoagulation effect of low molecular weight heparin (LMWH) combination with warfarin at the early stage at the treatment of intracranial venous sinus thrombosis.Methods 80 cases of intracranial venous sinus thrombosis patients in people's hospital of Xinjiang Uygur autononous region from January 2010 to December 2014 were chosen to be analyzed retrospectively.37 cases in observation group were treated with low molecular heparin (LMWH) in combination with warfarin, and 43 cases in control group were treated with warfarin.The clinical curative effect between two groups was compared post-treatment.Results The effective rate in observation group was 91.89%, which was significantly higher than 67.44% in control group (P<0.05) .The recanalization rate of involved intracerebral venous in observation group was 89.19%, which was significantly higher than 67.29% in control group(P<0.05).After treatment, the prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) were higher and fibrinogen (FBG) in both groups was lower than those pre-treatment(P<0.05).The PT and APTT was higher and FBG was lower in observation group than those in control group(P<0.05).Conclusion Low molecular weight heparin in combination with warfarin worked well than single warfarin in the treatment of intracranial venous sinus thrombosis.
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@#ObjectiveTo study how to diagnose thrombosis of intracranial venous sinus and cerebral venous thrombosis(CVT). Methods6 cases with intracranial venous sinus and CVT were analysed by clinical features and imaging signs. ResultsMost patients had symptoms and signs of intracranial hypertension. Some patients manifested symptoms of whole brain or focal neurological deficits. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) play important roles for the diagnosis of intracranial venous sinus and CVT, however, digital subtraction angiography (DSA) is one of the most reliable method for early diagnosis of the above diseases.Conclusions According to clinical features and imaging signs, intracranial venous sinus and CVT could be diagnosed accurately .