Mahale Rohan, Mehta Anish, Varma Ravi Gopal, Hegde Alangar S, Acharya Purushottam T, Srinivasa Rangasetty
Department of Neurosurgery, MS Ramaiah Medical College & Hospital, Bangalore, Karnataka, 560054, India.
J Thromb Thrombolysis. 2017 May;43(4):530-539. doi: 10.1007/s11239-017-1489-x.
Cerebral venous sinus thrombosis (CVST) is common in Asians, accounting for 15% of all strokes in the young. CVST causing malignant cerebral oedema with brain herniation and death are referred as malignant CVST. This study was aimed at evaluating the outcome of patients and factors predicting the outcome with malignant CVST after decompressive surgery. It was a retrospective, observational, single centre, hospital-based and cross-sectional study. Records of patients with malignant CVST who had decompressive surgery were analysed. Over 5 years (2010-2015), 30 patients (15 men and 15 women) underwent decompressive surgery. In univariate analysis, age more than 50 years (p = 0.05); presence of midline shift of more than 10 mm (p = 0.03) and total effacement of basal cisterns (p = 0.01) had significant correlation with poor outcome. On multivariate analysis, presence of midline shift of more than 10 mm (p = 0.01) was a significant predictor of poor outcome. Decompressive surgery is a life saving therapeutic intervention in patients with malignant CVST and more than two-thirds of patient shows favourable outcome. Age more than 50 years, midline shift >10 mm and total effacement of basal cisterns determine poor outcome following decompressive surgery.
脑静脉窦血栓形成（CVST）在亚洲人中很常见，占年轻人群所有中风病例的15%。导致恶性脑水肿伴脑疝形成及死亡的CVST被称为恶性CVST。本研究旨在评估减压手术后恶性CVST患者的预后情况以及预测预后的因素。这是一项回顾性、观察性、单中心、基于医院的横断面研究。对接受减压手术的恶性CVST患者的记录进行了分析。在5年期间（2010 - 2015年），30例患者（15例男性和15例女性）接受了减压手术。单因素分析显示，年龄超过50岁（p = 0.05）；中线移位超过10mm（p = 0.03）以及脑基底池完全消失（p = 0.01）与预后不良显著相关。多因素分析表明，中线移位超过10mm（p = 0.01）是预后不良的显著预测因素。减压手术是治疗恶性CVST患者的一种挽救生命的治疗干预措施，超过三分之二的患者显示出良好的预后。年龄超过50岁、中线移位>10mm以及脑基底池完全消失决定了减压手术后的不良预后。
