Bentley J Nicole, Figueroa Ramón E, Vender John R
Departments of Neurosurgery, Medical College of Georgia, Augusta, Georgia, USA
Neurosurg Focus. 2009 Nov;27(5):E4. doi: 10.3171/2009.8.FOCUS09166.
Cerebral venous thrombosis is an uncommon cause of stroke but remains a challenge for physicians faced with this diagnosis largely due to the variability in presentation. Anticoagulation, typically with intravenous heparin, remains the mainstay of treatment for stable patients and is sufficient in the majority of cases. However, a significant mortality rate exists for cerebral venous thrombosis due to patients who deteriorate or do not adequately respond to initial treatments. It is in these patients that more aggressive interventions must be undertaken. The neurosurgeon is often called on, either acutely for initial evaluation of the stroke or venous hemorrhage or after the failure of initial therapy for clot evacuation, hemicraniectomy, or thrombectomy. A proper workup must include a search for an underlying, correctable cause as well as thorough follow-up with correction of identified risk factors to decrease the risk of recurrent disease.
脑静脉血栓形成是一种不常见的中风病因，但对于面临这一诊断的医生来说仍是一项挑战，这主要是由于其临床表现的多变性。抗凝治疗，通常采用静脉注射肝素，仍然是稳定患者的主要治疗方法，并且在大多数情况下是足够的。然而，由于病情恶化或对初始治疗反应不佳的患者，脑静脉血栓形成存在显著的死亡率。正是在这些患者中，必须采取更积极的干预措施。神经外科医生经常被召集，要么在急性发作时对中风或静脉出血进行初步评估，要么在初始治疗失败后进行血凝块清除、颅骨切开术或血栓切除术。适当的检查必须包括寻找潜在的、可纠正的病因，以及对已确定的危险因素进行彻底的随访以降低疾病复发的风险。
