Bousser Marie-Germaine, Ferro José M
AP-HP Hôpital Lariboisière-Service de Neurologie, Paris, France.
Lancet Neurol. 2007 Feb;6(2):162-70. doi: 10.1016/S1474-4422(07)70029-7.
Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age, including in neonates, and it accounts for 0.5% of all stroke. The widespread use of neuroimaging now allows for early diagnosis and has completely modified our knowledge on this disorder. CVT is more common than previously thought and it is recognised as a non-septic disorder with a wide spectrum of clinical presentations, numerous causes, and usually a favourable outcome with a low mortality rate. MRI with T1, T2, fluid-attenuated inversion recovery, and T2* sequences combined with magnetic resonance angiography are the best diagnostic methods. D-dimer concentrations are raised in most patients but normal D-dimers do not rule out CVT, particularly in patients who present with isolated headache. Heparin is the first-line treatment, but in a few cases more aggressive treatments, such as local intravenous thrombolysis, mechanical thrombectomy, and decompressive hemicraniectomy, may be required.
脑静脉血栓形成（CVT）是一种罕见的脑血管疾病，可发生于任何年龄，包括新生儿，占所有卒中的0.5%。神经影像学的广泛应用现在使得早期诊断成为可能，并彻底改变了我们对这种疾病的认识。CVT比以前认为的更常见，它被认为是一种非感染性疾病，具有广泛的临床表现、众多病因，通常预后良好，死亡率低。采用T1、T2、液体衰减反转恢复序列和T2*序列的MRI联合磁共振血管造影是最佳诊断方法。大多数患者的D-二聚体浓度升高，但D-二聚体正常并不能排除CVT，特别是对于以孤立性头痛为表现的患者。肝素是一线治疗药物，但在少数情况下，可能需要更积极的治疗，如局部静脉溶栓、机械取栓和减压性颅骨切除术。
