University of Missouri Health Care, Columbia, Missouri, USA,
Staten Island University Hospital, Northwell Health, Staten Island, New York, USA.
Eur Neurol. 2020;83(4):369-379. doi: 10.1159/000509802. Epub 2020 Sep 2.
BACKGROUND: Cerebral sinus venous thrombosis (CSVT) is a relatively rare, potentially fatal neurological condition that can be frequently overlooked due to the vague nature of its clinical and radiological presentation. A literature search on PubMed using the keyword "Cerebral sinus venous thrombosis" was performed. We searched for the epidemiology, risk factors, pathophysiology, clinical features, diagnosis, and treatment of CSVT. All full-text articles in the last 10 years, in adults (>18 years), and the English language were included. We aim to give a comprehensive review of CSVT, with a primary focus on the management of the disease. SUMMARY: The literature search revealed 404 articles that met our criteria. CSVT is a relatively rare condition that accounts for approximately 1% of all forms of stroke. They can be subdivided into acute, subacute, and chronic forms based on the time of onset of clinical symptoms. It is a multifactorial disease, and the major forms of clinical presentation include isolated intracranial hypertension syndrome, focal neurological deficits, and cavernous sinus syndrome. MRI with magnetic resonance venogram (MRV) is considered the gold standard for diagnosis. Anticoagulation with heparin or low-molecular-weight heparin is the mainstay of treatment. Endovascular management is indicated for those cases with severe symptoms or worsening of symptoms despite anticoagulation therapy. Favorable outcomes have been reported in patients who receive early diagnosis and treatment. CONCLUSION: CSVT is a potentially fatal neurological condition that is often under-diagnosed due to its nonspecific presentation. Timely diagnosis and treatment can reduce morbidity and mortality, remarkably improving the outcome in affected individuals.
背景:脑窦静脉血栓形成(CSVT)是一种相对罕见的、潜在致命的神经系统疾病,由于其临床表现和影像学表现较为模糊,因此经常被忽视。我们在 PubMed 上使用关键字“Cerebral sinus venous thrombosis”进行了文献检索。我们搜索了 CSVT 的流行病学、危险因素、病理生理学、临床特征、诊断和治疗。所有在过去 10 年内发表的、针对成人(>18 岁)的、英文全文文章均被纳入。我们旨在对 CSVT 进行全面综述,主要关注疾病的管理。
摘要:文献检索共显示 404 篇符合标准的文章。CSVT 是一种相对罕见的疾病,约占所有中风类型的 1%。根据临床症状出现的时间,可将其分为急性、亚急性和慢性。它是一种多因素疾病,主要的临床表现形式包括孤立性颅内压增高综合征、局灶性神经功能缺损和海绵窦综合征。磁共振成像(MRI)联合磁共振静脉造影(MRV)被认为是诊断的金标准。肝素或低分子肝素抗凝是治疗的主要方法。对于那些有严重症状或尽管抗凝治疗后症状仍在恶化的患者,血管内治疗是指征。早期诊断和治疗可使患者获得良好的预后。
结论:CSVT 是一种潜在致命的神经系统疾病,由于其非特异性表现,常常被漏诊。及时诊断和治疗可以降低发病率和死亡率,显著改善患者的预后。
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