Hocker Sara E, Dafer Rima M, Hacein-Bey Lotfi
Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois 60153, USA.
J Stroke Cerebrovasc Dis. 2008 Nov-Dec;17(6):429-32. doi: 10.1016/j.jstrokecerebrovasdis.2008.07.001.
Cerebral venous and dural sinus thrombosis (CVDST) is a rare but not uncommon life-threatening disease accounting for less than 1% of stroke, affecting people of any age group, predominantly the extremes of age. CVDST carries a variable prognosis: although the majority of cases are associated with complete recovery, outcome may be fatal in less than 10% of patients. Thrombolysis has been widely used in CVDST in patients with rapidly deteriorating symptoms who fail to improve despite adequate anticoagulation, but the exact therapeutic time window remains unclear. We report a case of CVDST with rapid clinical deterioration despite therapeutic anticoagulation treated with direct endovascular thrombolysis with intravenous recombinant tissue plasminogen activator 1 week after presentation with complete recovery, and we present a review of the literature on the efficacy and safety of thrombolysis in CVDST.
脑静脉和硬脑膜窦血栓形成（CVDST）是一种罕见但并非不常见的危及生命的疾病，占中风的比例不到1%，可发生于任何年龄组，以年龄两端者为主。CVDST的预后各不相同：虽然大多数病例可完全康复，但不到10%的患者可能会死亡。对于症状迅速恶化且尽管进行了充分抗凝治疗仍无改善的CVDST患者，溶栓疗法已被广泛应用，但其确切的治疗时间窗仍不清楚。我们报告一例CVDST患者，尽管进行了治疗性抗凝，但临床症状仍迅速恶化，在出现症状1周后采用静脉注射重组组织型纤溶酶原激活剂进行直接血管内溶栓治疗，最终完全康复。我们还对溶栓治疗CVDST的疗效和安全性进行了文献综述。
