Zimny Anna, Dziadkowiak Edyta, Bladowska Joanna, Chojdak-Łukasiewicz Justyna, Loster-Niewińska Aleksandra, Sąsiadek Marek, Paradowski Bogusław
Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland.
Department of Neurology, Medical University Hospital, Wrocław, Poland.
Adv Clin Exp Med. 2017 Oct;26(7):1113-1122. doi: 10.17219/acem/66778.
Cerebral venous thrombosis (CVT) is a rare condition which constitutes 0.5-1% of all strokes. The clinical and radiological picture of CVT is non-specific and can mimic other disorders.
The aim of the study was to retrospectively evaluate and correlate clinical and radiological symptoms presented by patients with CVT, both in the initial and follow-up neurological and neuroimaging examinations, with a special emphasis on diagnostic difficulties.
Material consisted of 11 patients with CVT (7 women, 4 men). The average age was 43.5, ranging from 23 to 69 years. Clinical symptoms, laboratory findings, risk factors and the results of neuroimaging examinations including CT, MRI and DSA were retrospectively analyzed and correlated.
All subjects developed superficial CVT and 1 also deep CVT, with no parenchymal lesions in 2 cases, non-hemorrhagic infarctions in 3 and hemorrhagic lesions in 6 subjects. The most frequent symptoms were headache, seizures and hemiparesis. The major risk factors were hormonal therapies in women and congenital thrombophilia. Factors influencing the clinical course and outcome the most were location and type of brain lesions, with hemorrhagic cortical infarctions bringing the worst prognosis and being associated with the highest rate of persistent neurological deficits, despite the rate of vessel recanalization.
In our opinion, quick diagnosis before parenchymal hemorrhagic lesions are visible on CT is of crucial importance and requires a constant alertness and good cooperation of neurologists and radiologists, especially in emergency settings.
脑静脉血栓形成（CVT）是一种罕见疾病，占所有中风的0.5 - 1%。CVT的临床和影像学表现不具有特异性，可模仿其他疾病。
本研究的目的是回顾性评估CVT患者在初始及随访的神经学和神经影像学检查中出现的临床和影像学症状，并特别强调诊断困难。
材料包括11例CVT患者（7例女性，4例男性）。平均年龄为43.5岁，范围在23至69岁之间。对临床症状、实验室检查结果、危险因素以及包括CT、MRI和DSA在内的神经影像学检查结果进行回顾性分析并相互关联。
所有受试者均发生浅表性CVT，1例还发生深部CVT，2例无实质病变，3例有非出血性梗死，6例有出血性病变。最常见的症状是头痛、癫痫发作和偏瘫。主要危险因素是女性的激素治疗和先天性血栓形成倾向。对临床病程和结局影响最大的因素是脑病变的部位和类型，出血性皮质梗死预后最差，尽管血管再通率较高，但持续性神经功能缺损发生率最高。
我们认为，在CT上可见实质出血性病变之前快速诊断至关重要，这需要神经科医生和放射科医生保持持续警惕并密切合作，尤其是在紧急情况下。
