Long Brit, Koyfman Alex, Runyon Michael S
Department of Emergency Medicine, San Antonio Military Medical Center, 3841 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
Department of Emergency Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
Emerg Med Clin North Am. 2017 Nov;35(4):869-878. doi: 10.1016/j.emc.2017.07.004. Epub 2017 Aug 24.
Headache is a common emergency department chief complaint. Although most are benign, emergency physicians must rapidly identify and manage the uncommon, sometimes subtle, presentation of headache from a life-threatening cause. Cerebral venous thrombosis imparts significant morbidity and mortality, and can be a challenging diagnosis. It most commonly occurs in those under 50 years of age with thrombosis of the cerebral veins/sinuses. Diagnosis is frequently delayed. The disease can present with 1 or more clinical syndromes, including intracranial hypertension with headaches, focal neurologic deficits, seizures, and encephalopathy. Diagnosis requires imaging. Treatment includes stabilization, management of complications, and anticoagulation.
头痛是急诊科常见的主诉。尽管大多数头痛是良性的,但急诊医生必须迅速识别并处理由危及生命的病因引起的不常见、有时很隐匿的头痛表现。脑静脉血栓形成会导致严重的发病率和死亡率,且可能是一个具有挑战性的诊断。它最常发生在50岁以下患有脑静脉/静脉窦血栓形成的人群中。诊断常常延迟。该疾病可表现为一种或多种临床综合征,包括伴有头痛的颅内高压、局灶性神经功能缺损、癫痫发作和脑病。诊断需要影像学检查。治疗包括病情稳定、并发症处理和抗凝治疗。