Bhat Sunil Jee, Kashyap Priyanka Vikas
Senior Resident,Shri Mahant Indiresh Hospital, Dehradun , Uttarakhand.
Assistant Professor, Shri Mahant Indiresh Hospital, Dehradun , Uttarakhand ;Corresponding Author.
J Assoc Physicians India. 2018 Jul;66(7):43-47.
CVT is an uncommon but important cause of stroke that is often misdiagnosed delaying its treatment. High suspicion is essential in early recognition and treatment.
To study the clinical features and etiology of patients with Cerebral Venous Thrombosis (CVT) and relation between septic and non septic CVT if any.
A prospective study was done in SMIH that enrolled 40 patients of CVT in 2 years duration (Jan 2014 to Dec 2015). The patients were diagnosed as CVT according to Magnetic Resonance Venogram (MRV) and clinical status.
Forty (40) patients of CVT were enrolled during 2 years period, most were females (22/30) and aged between 18-50 years (mean age 30.2+4.9). Most common presentation was headache followed by seizures and focal deficit. Other symptoms encountered were cranial nerve palsies, meningeal signs, papilloedema. Most common headache type was tension type headache. Most common cranial nerve involvement was abduscens nerve. Superior Sinus Thrombosis (SSS) involvement was most commonly thrombosed followed by its involvement with other sinuses. Isolated lateral sinus involvement also seen. On screening for cause, non septic CVT outnumbered septic CVT (22/8) and the most common cause of non septic CVT was unknown followed by coagulation defect. Among septic CVT group puerperial sepsis in females and mastoiditis in males were the dominant cause.
Septic CVT prognosis had better than non septic CVT. Hence, CVT presents with wide range of presentations and anticoagulation is the treatment. Septic CVT if intervened timely with proper antibiotics have better prognosis. Antibiotics are the mainstay of therapy for septic CVT.
脑静脉血栓形成(CVT)是一种罕见但重要的中风病因,常被误诊,从而延误治疗。高度怀疑对于早期识别和治疗至关重要。
研究脑静脉血栓形成(CVT)患者的临床特征、病因,以及感染性和非感染性CVT之间的关系(若存在)。
在SMIH进行了一项前瞻性研究,在2年期间(2014年1月至2015年12月)纳入了40例CVT患者。根据磁共振静脉血管造影(MRV)和临床状况将患者诊断为CVT。
在2年期间纳入了40例CVT患者,大多数为女性(22/30),年龄在18 - 50岁之间(平均年龄30.2 + 4.9)。最常见的表现是头痛,其次是癫痫发作和局灶性神经功能缺损。其他症状包括颅神经麻痹、脑膜刺激征、视乳头水肿。最常见的头痛类型是紧张型头痛。最常受累的颅神经是展神经。上矢状窦血栓形成(SSS)受累最常见,其次是其与其他鼻窦的受累情况。也可见孤立的外侧窦受累。在病因筛查中,非感染性CVT多于感染性CVT(22/8),非感染性CVT最常见的病因不明,其次是凝血缺陷。在感染性CVT组中,女性的产褥期败血症和男性的乳突炎是主要病因。
感染性CVT的预后优于非感染性CVT。因此,CVT有广泛的表现,抗凝是治疗方法。感染性CVT如果及时用适当的抗生素进行干预,预后较好。抗生素是感染性CVT治疗的主要手段。