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脑静脉窦血栓形成:病例系列分析

Cerebral venous-sinus thrombosis: a case series analysis.

作者信息

Ashjazadeh Nahid, Borhani Haghighi Afshin, Poursadeghfard Maryam, Azin Hoseinjan

机构信息

Shiraz Neurosciences Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Iran J Med Sci. 2011 Sep;36(3):178-82.

Abstract

BACKGROUND

Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women.

METHODS

We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated.

RESULTS

The patients' mean age was 34.01±10.25. Eighty seven (70.16%) were women and 37 (29.83%) were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51%) women took oral contraceptive pills. Twenty of 57 women (35.08%) took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%). High mortality and morbidity rates (14.51% and 35.48%, respectively) were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001) and evidence of hemorrhage in primary CT scan (P=0.005).

CONCLUSION

Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it.

摘要

背景

脑静脉窦血栓形成是一种少见但重要的卒中病因,尤其在年轻女性中。

方法

我们进行了一项回顾性描述性分析研究,纳入了2000年1月至2008年3月转诊至设拉子医科大学内马齐医院的124例脑静脉窦血栓形成患者,并对其人口统计学、病因学、放射学和预后特征进行了评估。

结果

患者的平均年龄为34.01±10.25岁。87例(70.16%)为女性,37例(29.83%)为男性。最常见的临床表现为头痛、视乳头水肿和癫痫发作。57例(65.51%)女性服用口服避孕药。57例女性中有20例(35.08%)服药超过1个月以便能在斋月禁食或进行朝觐仪式。与此同时,她们发生了脑静脉窦血栓形成。上矢状窦,无论有无侧窦受累,是最常受累的部位(70.96%)。患者的死亡率和发病率较高(分别为14.51%和35.48%)。入院时的不良预后因素为昏迷和昏睡(P=0.001)以及初次CT扫描时有出血证据(P=0.005)。

结论

服用口服避孕药是与脑静脉窦血栓形成相关的主要因素。本研究的临床表现、预后因素、常见受累窦及影像学表现与其他研究相似。卫生保健政策制定者应制定一项计划,警告易患脑静脉窦血栓形成的女性,教育她们预防该病的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/081f/3556770/7c502949d3c0/IJMS-36-178-g001.jpg

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