Song Si-Ying, Lan Duo, Wu Xiao-Qin, Meng Ran
Department of Neurology, Xuanwu Hospital, Capital Medical University, Chang Chun Road 45, Xicheng, Beijing, China.
Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China.
J Thromb Thrombolysis. 2021 Apr;51(3):734-740. doi: 10.1007/s11239-020-02229-x.
Cerebral cortical vein thrombosis (CCVT) is a rare type of cerebral venous thrombosis, which is frequently combined with cerebral venous sinus thrombosis (CVST). We aimed to compare the difference of clinical features between the isolated and the combined subtypes of CCVT. A literature search was conducted utilizing the PubMed Central and EMBASE databases to identify studies up to Dec 2019. Clinical manifestations, presumable risk factors, imaging modalities, radiological findings, treatment, and prognosis in patients with CCVT were recorded. 335 publications were identified (n = 325, 141 males and 184 females, mean age 40.24 ± 16.26 years). Headaches (46.8%), motor/sensory disorders (43.3%), and seizures (42.5%) were commonly seen. Pregnancy/postpartum (n = 29), oral contraception use (n = 15), fertility drug use (n = 4) ranked the top three comorbidities of CCVT in female patients, while for general populations, thrombophilia, invasive interventions in the cerebrospinal system, as well as malignancy, would be the common risk factors. MRV and DSA were more likely to confirm diagnosis. More than 30% of CCVT presented brain lesions, including infarction (6.5%) and hemorrhage (24.0%). Isolated CCVT was prone to develop hemorrhagic infarction while combined CCVT was more likely to have ischemic lesions. More than 90% of the patients acquired good outcomes at discharge or short-term follow-up (within one year). There is a difference between Isolated CCVT and CCVT combined CVST on the sites and types of brain lesions. MRV and DSA may contribute to the final diagnosis. Most patients acquired complete or partial recovery of clinical symptoms or imaging presentations after long-term anticoagulation (3-6 months).
大脑皮质静脉血栓形成（CCVT）是一种罕见的脑静脉血栓形成类型，常与脑静脉窦血栓形成（CVST）合并出现。我们旨在比较孤立型和合并型CCVT临床特征的差异。利用PubMed Central和EMBASE数据库进行文献检索，以确定截至2019年12月的研究。记录CCVT患者的临床表现、可能的危险因素、影像学检查方法、影像学表现、治疗及预后情况。共识别出335篇出版物（n = 325，男性141例，女性184例，平均年龄40.24±16.26岁）。常见症状包括头痛（46.8%）、运动/感觉障碍（43.3%）和癫痫发作（42.5%）。妊娠/产后（n = 29）、使用口服避孕药（n = 15）、使用促生育药物（n = 4）是女性CCVT患者排名前三的合并症，而对于普通人群，血栓形成倾向、脑脊液系统的侵入性干预以及恶性肿瘤是常见的危险因素。磁共振静脉血管造影（MRV）和数字减影血管造影（DSA）更有可能确诊。超过30%的CCVT患者出现脑部病变，包括梗死（6.5%）和出血（24.0%）。孤立型CCVT易发生出血性梗死，而合并型CCVT更易出现缺血性病变。超过90%的患者在出院时或短期随访（1年内）获得良好预后。孤立型CCVT与合并CVST的CCVT在脑部病变的部位和类型上存在差异。MRV和DSA可能有助于最终诊断。大多数患者在长期抗凝治疗（3 - 6个月）后临床症状或影像学表现获得完全或部分恢复。
