静脉窦血栓形成的管理

Management of Venous Sinus Thrombosis.

作者信息

Sader Nicholas, de Lotbinière-Bassett Madeleine, Tso Michael K, Hamilton Mark

机构信息

Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Foothills Hospital, 12th Floor, 1403 - 29th Street Northwest, Calgary, Alberta T2N 2T9, Canada.

Adult Hydrocephalus Program, Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Adult Hydrocephalus Clinical Research Network, Foothills Hospital, 12th Floor, 1403 - 29th Street Northwest, Calgary, Alberta T2N 2T9, Canada.

出版信息

Neurosurg Clin N Am. 2018 Oct;29(4):585-594. doi: 10.1016/j.nec.2018.06.011.

DOI:10.1016/j.nec.2018.06.011

PMID:30223971

Abstract

Cerebral venous sinus thrombosis (CVST) is a rare subtype of cerebrovascular disease representing 0.5% of strokes. The signs and symptoms of CVST are often nonspecific, and variable in duration, with the common results being delayed diagnosis and treatment. Increased awareness in the medical community and advancements in imaging modalities have produced faster diagnosis with improved patient outcomes. The preferred initial treatment is with a low molecular weight heparin. After the acute stage of CVST, treatment with a vitamin K antagonist (oral anticoagulant therapy) is recommended. Current evidence suggests that in the future, factor Xa inhibitor drugs may be used for long-term therapy.

摘要

脑静脉窦血栓形成（CVST）是一种罕见的脑血管疾病亚型，占中风的0.5%。CVST的体征和症状通常不具有特异性，且持续时间各异，常见结果是诊断和治疗延迟。医学界认识的提高和成像方式的进步使得诊断更快，患者预后得到改善。首选的初始治疗是使用低分子量肝素。在CVST急性期过后，建议使用维生素K拮抗剂（口服抗凝治疗）。目前的证据表明，未来因子Xa抑制剂药物可能用于长期治疗。