Wang Xiaotong, Sun Xuwen, Liu Hong
Department of Neurology, Yantai Yuhuangding Hospital, Yantai 264000, P.R. China.
Exp Ther Med. 2012 Nov;4(5):923-927. doi: 10.3892/etm.2012.697. Epub 2012 Sep 4.
The present study aimed to summarize the clinical characteristics and experiences of misdiagnoses of cerebral venous thrombosis (CVT). A total of 18 patients with CVT who received treatment between September 2009 and August 2011 were enrolled. Of the patients, 13 were females and 5 were males with an average age of 39 years. Clinical manifestations and characteristics according to cerebrospinal fluid examination and imaging were summarized retrospectively. CVT principally manifested as headaches, papilledema, psychiatric symptoms, impaired consciousness and seizure disorders, with or without neurological defects. A combination of magnetic resonance imaging (MRI) and venography (MRV) was demonstrated to be an effective method for CVT diagnosis. Of the 18 patients, 8 were misdiagnosed, as a result of the lack of further examination due to undefined etiology, atypical clinical manifestations and ambiguous neuroimaging direct signs. The clinical symptoms of CVT are aspecific, as a result of which misdiagnosis tends to occur. For patients with intracranial hypertension accompanied with or without neurological defects, MRI combined with MRV can improve the accuracy of CVT diagnosis.
本研究旨在总结脑静脉血栓形成(CVT)的临床特征及误诊经验。纳入了2009年9月至2011年8月间接受治疗的18例CVT患者。其中,女性13例,男性5例,平均年龄39岁。回顾性总结了根据脑脊液检查和影像学检查得出的临床表现及特征。CVT主要表现为头痛、视乳头水肿、精神症状、意识障碍和癫痫发作,伴或不伴有神经功能缺损。磁共振成像(MRI)和静脉造影(MRV)相结合被证明是诊断CVT的有效方法。18例患者中,8例因病因不明、临床表现不典型及神经影像学直接征象不明确而缺乏进一步检查,从而被误诊。CVT的临床症状缺乏特异性,因此容易发生误诊。对于伴有或不伴有神经功能缺损的颅内高压患者,MRI联合MRV可提高CVT诊断的准确性。