Mohamed Mohamed Wael F, Aung Su Sandi, Mereddy Nakul, Ramanan Sruthi Priyavadhana, Hamid Pousette
Neurological Surgery, Royal London Hospital, London, GBR.
Medicine and Surgery, University of Medicine 1, Yangon, MMR.
Cureus. 2020 Dec 17;12(12):e12135. doi: 10.7759/cureus.12135.
Cerebral venous and dural sinus thrombosis (CVST) is predominantly a disease of young people. It accounts for 0.5% of all strokes, and patients usually have good outcomes. However, a minority of patients may present with elevated intracranial pressure characteristics in a serious illness type and may die from brain herniation if not treated promptly. Decompressive craniectomy (DC) is the only treatment modality that can prevent death in such cases of imminent brain herniation. Unfortunately, due to the condition's rarity and ethical concerns, randomized controlled trials are not available. This review assessed the available literature on cerebral venous and dural sinus thrombosis in different age groups and decompressive craniectomy in cerebral venous and dural sinus thrombosis. It revealed that decompressive surgery is extremely effective when done early and for the correct indications with patients achieving excellent functional outcomes post-surgery. Decompressive surgery is recommended in rapidly deteriorating patients with computed tomography (CT) scan evidence of basal cisterns effacement, a mass effect from haemorrhage and/or infarction, and significant midline shift.
脑静脉和硬脑膜窦血栓形成（CVST）主要是一种年轻人的疾病。它占所有中风的0.5%，患者通常预后良好。然而，少数患者可能以重症类型出现颅内压升高的特征，如果不及时治疗，可能死于脑疝。减压性颅骨切除术（DC）是唯一能在这种即将发生脑疝的情况下预防死亡的治疗方式。不幸的是，由于该病症罕见且存在伦理问题，尚无随机对照试验。本综述评估了不同年龄组脑静脉和硬脑膜窦血栓形成以及脑静脉和硬脑膜窦血栓形成中减压性颅骨切除术的现有文献。结果显示，早期且针对正确适应症进行减压手术极为有效，患者术后功能预后良好。对于计算机断层扫描（CT）显示基底池消失、出血和/或梗死导致的占位效应以及明显中线移位的快速恶化患者，建议进行减压手术。
