Stolz Erwin, Trittmacher Susan, Rahimi Anousha, Gerriets Tibo, Röttger Carina, Siekmann Ralf, Kaps Manfred
Department of Neurology, Justus-Liebig University, Giessen, Germany.
Stroke. 2004 Feb;35(2):544-7. doi: 10.1161/01.STR.0000112972.09096.65. Epub 2004 Jan 8.
Recanalization in dural sinus thrombosis (DST) has been observed previously; however, systematic prospective data are lacking. The influence of recanalization on DST outcome has not yet been thoroughly evaluated.
Thirty-seven consecutive patients with DST were prospectively examined. Neurological deficits were graded with the National Institutes of Health Stroke Scale (NIHSS) on hospital admission and discharge. Functional outcome was assessed with the modified Rankin Scale (mRS) on hospital discharge and after 12 months. All patients were treated with intravenous heparin in the acute stage of illness, followed by oral anticoagulation for 12 months. Imaging follow-up with MR angiography and, in a few cases, with CT or conventional angiography was performed on hospital discharge and after 6 and 12 months.
Twelve-month functional outcome was excellent in 89% of patients with an mRS of 0 or 1. A recanalization rate of 60% was already observed on hospital discharge (22+/-6 days); thereafter, recanalization rates increased insignificantly. Early recanalization was not related to NIHSS score on hospital discharge or an mRS of 0 on discharge or after 12 months.
We found a high frequency of early recanalization but without influence on clinical outcome parameters. Frequent imaging follow-ups in DST are not useful because they provide no information on patient outcome.
硬膜窦血栓形成（DST）的再通现象此前已有观察报道；然而，缺乏系统的前瞻性数据。再通对DST预后的影响尚未得到充分评估。
对37例连续性DST患者进行前瞻性检查。入院及出院时采用美国国立卫生研究院卒中量表（NIHSS）对神经功能缺损进行评分。出院时及12个月后采用改良Rankin量表（mRS）评估功能预后。所有患者在疾病急性期接受静脉肝素治疗，随后口服抗凝药12个月。出院时以及6个月和12个月后进行磁共振血管造影成像随访，少数病例采用CT或传统血管造影。
mRS评分为0或1的患者中，89%在12个月时功能预后良好。出院时（22±6天）已观察到再通率为60%；此后，再通率无显著增加。早期再通与出院时的NIHSS评分或出院时及12个月后的mRS评分为0无关。
我们发现早期再通的频率较高，但对临床结局参数无影响。对DST进行频繁的影像学随访并无用处，因为它们无法提供有关患者预后的信息。
