Alami B, Boujraf S, Quenum L, Oudrhiri A, Alaoui Lamrani M Y, Haloua M, Boubbou M, Maâroufi M
Service de radiologie, faculté de médecine et de pharmacie, université Sidi Mohammed Ben Abdellah, CHU Hassan II Fès, Fès, Maroc; Laboratoire de biophysique et méthodes IRM, faculté de médecine et de pharmacie, université Sidi Mohammed Ben Abdellah, Fès, Maroc.
Laboratoire de biophysique et méthodes IRM, faculté de médecine et de pharmacie, université Sidi Mohammed Ben Abdellah, Fès, Maroc.
J Med Vasc. 2019 Dec;44(6):387-399. doi: 10.1016/j.jdmv.2019.09.011. Epub 2019 Oct 1.
The work's purpose is to make a general review on the various clinical-radiological aspects and the management of cerebral venous thrombosis (CVT) in our hospital and compare them to those described in the literature.
Our series included 62 patients aged over 18 years, collected over 7 years (2009-2016) in the radiology department of the CHU Hassan II of Fez (Morocco), in which the radiological diagnosis of TVC was retained. Our patients have benefited from a brain CT scan and brain MRI. Clinical and radiological characteristics and post-treatment progression were described.
The average age was 35 years with a female predominance; sex ratio 3.76 (49F/13H). The symptomatology was non-specific, made mainly of headaches, comic crises, disturbances of consciousness and focal signs. The upper longitudinal sinus was dominant topography (51.61%). The etiological factors were varied: infectious (sinusitis, chronic otitis media, oto-mastoiditis, bacterial meningitis, and septicemia), gyneco-obstetrical (oral contraception, pregnancy, and postpartum), systemic (Behçet diseases, polycythemia of Vaquez, paraneoplastic syndrome, antiphospholipid syndrome), local (head trauma), undetermined etiological factors. The CT scan, but especially the cerebral MRI, made it possible to make the diagnosis but also to direct towards the etiology.
Cerebral MRI is currently the best imaging in the diagnosis of CTV, allowing an accurate assessment of its location, extent and impact on the cerebral parenchyma. Multiple conditions are responsible for CTVs. Therapeutic management is based on heparinotherapy and etiological treatment.
这项工作的目的是对我院脑静脉血栓形成(CVT)的各种临床放射学方面及管理进行全面综述,并将其与文献中描述的情况进行比较。
我们的系列研究纳入了62例年龄超过18岁的患者,这些患者于7年(2009 - 2016年)期间在摩洛哥非斯哈桑二世大学医院放射科收集,其中保留了TVC的放射学诊断。我们的患者接受了脑部CT扫描和脑部MRI检查。描述了临床和放射学特征以及治疗后的进展情况。
平均年龄为35岁,女性占主导;性别比为3.76(49名女性/13名男性)。症状不具有特异性,主要由头痛、抽搐发作、意识障碍和局灶性体征组成。上矢状窦是主要受累部位(51.61%)。病因多种多样:感染性(鼻窦炎、慢性中耳炎、耳乳突炎、细菌性脑膜炎和败血症)、妇产科(口服避孕药、妊娠和产后)、全身性(白塞病、瓦克斯真性红细胞增多症、副肿瘤综合征、抗磷脂综合征)、局部性(头部外伤)、病因不明。CT扫描,尤其是脑部MRI,不仅有助于做出诊断,还能指向病因。
目前,脑部MRI是诊断CTV的最佳影像学检查,能够准确评估其位置、范围以及对脑实质的影响。多种情况可导致CTV。治疗管理基于肝素治疗和病因治疗。