Departamento de Medicina Interna-Neurología, Hospital Ángeles del Pedregal (GG), México DF, México.
Neurologia. 2011 Oct;26(8):488-98. doi: 10.1016/j.nrl.2010.09.013. Epub 2010 Nov 18.
Cerebral venous thrombosis (CVT) is still a significant diagnostic and therapeutic challenge, due to its high variability of clinical manifestations and its lack of a clear therapeutic consensus.
A search of the medical literature was made through PubMed using the conjoined terms of CVT and epidemiology (428 results), pathophysiology (504 results), aetiology (2714 results), diagnosis (2802 results), treatment (2173 results) and outcome (648 results). Original and review publications deemed to be useful for this review were selected. Classical and historical works on CVT were also included.
The present paper reviews the fundamental aspects of the epidemiology, pathophysiology and aetiology of CVT. There is a comparison of the most common initial clinical manifestations along with a description of the most important neuroradiological studies needed to establish a diagnosis, all based on multiple published series. Moreover, in order to serve as an important tool in both clinical practice and continuing research, there is also an analysis of recent evidence on treatment and prognosis.
CVT represents approximately 0.5% of all stroke cases worldwide. Headache, focal deficits and seizures are the most frequent initial clinical manifestations, representing 89%, 50%, and 35% of appearances, respectively. Magnetic resonance imaging (MRI) in combination with magnetic resonance venography has proved to have the highest sensitivity and specificity in establishing a diagnosis. An equal alternative to MRI is computed tomography venography due to similar diagnostic results. Pharmacological treatment with heparin is widely accepted today. Recurrence and mortality rates of CVT are 2.8 per 100 cases and 10%, respectively, despite of anticoagulation treatment.
由于脑静脉血栓形成（CVT）临床表现多样且缺乏明确的治疗共识，因此仍然是一个重大的诊断和治疗挑战。
通过 PubMed 联合使用 CVT 和流行病学（428 个结果）、病理生理学（504 个结果）、病因学（2714 个结果）、诊断（2802 个结果）、治疗（2173 个结果）和结局（648 个结果）进行了医学文献检索。选择了被认为对本综述有用的原始和综述出版物。还包括了 CVT 的经典和历史著作。
本文回顾了 CVT 的流行病学、病理生理学和病因学的基本方面。比较了最常见的初始临床表现，并描述了建立诊断所需的最重要的神经影像学研究，所有这些都是基于多个已发表的系列。此外，为了在临床实践和持续研究中作为重要工具，还分析了最近关于治疗和预后的证据。
CVT 约占全球所有中风病例的 0.5%。头痛、局灶性缺损和癫痫发作是最常见的初始临床表现，分别占 89%、50%和 35%。磁共振成像（MRI）联合磁共振静脉造影已被证明在诊断方面具有最高的敏感性和特异性。由于诊断结果相似，计算机断层静脉造影术是 MRI 的同等替代方法。肝素的药物治疗目前被广泛接受。尽管进行了抗凝治疗，CVT 的复发率和死亡率分别为每 100 例 2.8 例和 10%。
