Early diagnosis and treatment of cerebral venous sinus thrombosis / 中华神经科杂志

ABSTRACT

Objective To investigate the clinical characteristics and treatment of cerebral venous sinus thrombosis(CVT) Methods Medical records, including age and the mode of onset, early symptoms, clinical presentations, findings of neuroimaging and cerebral spinal fluid (CSF), were analyzed retrospectively in 60 CVT patients (male 34 and female 26) Results CVT was most commonly seen in people of 20～40 years old, and the onset was acute in roughly 88% of cases. The first and most common symptoms included headache (87%) and vomit (61%), with or without focal deficits and/or seizures Neuroimaging fingdings showed 52% parenchymal focal infarction (with 39% hemorrhagic infarction or hematoma) and cerebral venous and sinus occlusions As for CSF examination,pressure increased remarkably,with WBC and protein normal or increased slightly (except for infection and cancer CVT). Dehydration, lumbar punctures, anticoagulation, local thrombolysis and etiologic treatment were utilized in the management of CVT, and better outcomes were achieved, with mortality rate of 10% Conclusions Headache, vomit with or without focal deficits and/or seizures as initial presentation should raise the suspicion of CVT, and its diagnosis can be further established by neuroimaging examination (combination of MRI and MRA). Early administration of heparin followed by oral anticoagulants for 3～6 months is recommended as first line treatment of CVT