Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China 200233.
Department of Neurosurgery, Taian Central Hospital, Taian, Shandong Province, China 271000.
Biomed Res Int. 2020 Dec 14;2020:6637692. doi: 10.1155/2020/6637692. eCollection 2020.
We identified adult CVST patients in our centers. Functional outcome and prevention strategy were extracted from medical records. Modified Rankin Scale (mRS) ≤ 1 is considered a good functional outcome.
A total of 113 patients were identified. The most common presenting symptoms were headache (86.72%) and nausea/vomiting (56.63%); the top two identified risk factors were local head/neck infection (27.43%) and pregnancy/puerperal period (19.47%). The medical encounter lag time was 0.04 d-120 d. Four enrolled patients were diagnosed as CVST again, and the interval time was 3-8 years from the first time. Thrombus was most frequently seen at superior sagittal sinus (53.10%) and sigmoid sinus (50.44%). 94 (83.19%) of the patients had good outcomes. In the acute phase, 91 (80.53%) patients received low molecular weight heparin, 29 (25.66%) took aspirin, 7 (6.19%) patients were put on low molecular weight heparin and aspirin together. During our follow up (6-24 m), there were 10 (8.85%) patients who suffered from thrombotic event recurrence. For the patients > 40 years old, they tended to suffer from neurological deficit (25.00%) and stupor/coma (16.67%) ( > 0.05), with a higher rate of hemorrhage (20.83%) and death (4.16%) when compared with the younger patients (10.77% and 1.53%, separately) ( > 0.05).
Functional outcome after CVST appears good. For the patients over 40-year-old, neurological deficit and altered consciousness were more common, accompanied by a higher rate of hemorrhage and mortality. The recurrent rate of CVST was low, longer-term follow up needed. The prevention strategy after CVST was uncertain, further studies needed.
我们在中心确定了成人 CVST 患者。从病历中提取功能结果和预防策略。改良 Rankin 量表(mRS)≤1 被认为是良好的功能结果。
共确定了 113 例患者。最常见的首发症状为头痛(86.72%)和恶心/呕吐(56.63%);前两个确定的危险因素是局部头/颈部感染(27.43%)和妊娠/产褥期(19.47%)。就诊延迟时间为 0.04120d。4 例患者再次被诊断为 CVST,时间间隔为首次发病后 38 年。血栓最常见于上矢状窦(53.10%)和乙状窦(50.44%)。94(83.19%)例患者预后良好。在急性期,91(80.53%)例患者接受低分子肝素治疗,29(25.66%)例患者服用阿司匹林,7(6.19%)例患者同时接受低分子肝素和阿司匹林治疗。在我们的随访(6-24m)期间,有 10(8.85%)例患者发生血栓事件复发。对于>40 岁的患者,他们更容易出现神经功能缺损(25.00%)和昏迷/昏睡(16.67%)(>0.05),出血(20.83%)和死亡(4.16%)的发生率高于年轻患者(分别为 10.77%和 1.53%)(>0.05)。
CVST 后的功能结果良好。对于>40 岁的患者,神经功能缺损和意识改变更为常见,出血和死亡率更高。CVST 的复发率较低,需要长期随访。CVST 后的预防策略不确定,需要进一步研究。