Crassard Isabelle, Soria Claudine, Tzourio Christophe, Woimant France, Drouet Ludovic, Ducros Anne, Bousser Marie-Germaine
Neurology Department, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France.
Stroke. 2005 Aug;36(8):1716-9. doi: 10.1161/01.STR.0000173401.76085.98. Epub 2005 Jul 14.
Cerebral venous thrombosis (CVT) is an infrequent variety of cerebrovascular disease with a wide spectrum of clinical presentations and a notoriously difficult diagnosis. Previous reports have emphasized the potential clinical utility of D-dimer assay in CVT diagnosis.
A rapid sensitive D-dimer assay was performed at entry in 73 patients with CVT <30 days duration, examined in our institution between 1999 and 2003.
The mean value of D-dimer levels was 1521 ng/mL; 7 patients (10% of all patients and 26% of those presenting with isolated headache) had values <500 ng/mL. In a multivariate analysis, isolated headache was the only variable associated with a negative D-dimer assay.
A negative D-Dimer assay does not confidently rule out CVT, particularly in the setting of recent isolated headache.
脑静脉血栓形成（CVT）是一种罕见的脑血管疾病，临床表现多样，诊断 notoriously 困难。既往报告强调了 D - 二聚体检测在 CVT 诊断中的潜在临床应用价值。
对 1999 年至 2003 年期间在我院就诊的 73 例病程小于 30 天的 CVT 患者入院时进行快速敏感的 D - 二聚体检测。
D - 二聚体水平的平均值为 1521 ng/mL；7 例患者（占所有患者的 10%，孤立性头痛患者的 26%）的值<500 ng/mL。多因素分析显示，孤立性头痛是与 D - 二聚体检测结果为阴性相关的唯一变量。
D - 二聚体检测结果为阴性并不能可靠地排除 CVT，尤其是在近期孤立性头痛的情况下。
