大脑深部静脉血栓形成的临床与放射学研究。

A clinico-radiological study of deep cerebral venous thrombosis.

机构信息

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli, Lucknow, Uttar Pradesh, 226014, India.

Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli, Lucknow, Uttar Pradesh, 226014, India.

出版信息

Neuroradiology. 2022 Oct;64(10):1951-1960. doi: 10.1007/s00234-022-02938-5. Epub 2022 Apr 25.

DOI:10.1007/s00234-022-02938-5

PMID:35462575

Abstract

PURPOSE

Isolated deep cerebral venous thrombosis (DCVT) may have different presentation and outcome compared to DCVT with additional sinus thrombosis. We compare clinico-radiological findings and outcomes of patients with isolated DCVT with those having additional sinus thrombosis.

METHODS

Forty-one DCVT patients with or without additional sinus thrombosis were included. Deep CVT was diagnosed if there was thrombosis of straight sinus, vein of Galen, internal cerebral vein, or basal vein of Rosenthal on MR venography (MRV). Isolated DCVT patients were classified as Group A and those with additional sinus thrombosis as Group B. The clinical features, risk factors, MRI findings, and outcomes at 1, 3, and 6 months were compared between Groups A and B.

RESULTS

Median age was 28 years, and 22 (54%) were females. Eight (19.5%) patients were in Group A and 33 (80.5%) in Group B. Group B patients had shorter duration of illness (7 vs 30 days; p = 0.01), frequent vomiting [25 (75.7%) vs 2 (25%); p = 0.01], and papilledema [13 (39%) vs 0 (0%); p = 0.04]. Risk factors were comparable. MRI revealed bilateral thalamic [5 (62.5%) vs 6 (18.2%)] and basal ganglia [(4 (50%) vs 6 (18.2%)] lesions more frequently in Group A. At 1 month, 2 (6%) patients died in Group B and none in Group A, and 24 had good outcome (50% Group A and 60.6% in Group B). At 3 months, 30 had good outcome (62.5% Group A and 80.6% in Group B). Improvement after 3 months was negligible.

CONCLUSION

Isolated DCVT is rare, and additional sinus thrombosis is associated with more severe illness and death. However, long-term outcomes in the survivors are similar between the two groups.

摘要

目的

孤立性大脑深部静脉血栓形成（DCVT）与伴有额外窦血栓形成的 DCVT 相比，可能具有不同的表现和结局。我们比较了孤立性 DCVT 患者与伴有额外窦血栓形成的患者的临床-影像学表现和结局。

方法

纳入了 41 例有或无额外窦血栓形成的 DCVT 患者。如果磁共振静脉造影（MRV）显示直窦、Galen 静脉、大脑内静脉或 Rosenthal 基底静脉血栓形成，则诊断为孤立性 DCVT。孤立性 DCVT 患者分为 A 组，伴有额外窦血栓形成的患者分为 B 组。比较两组患者的临床特征、危险因素、MRI 表现和 1、3 和 6 个月的结局。

结果

中位年龄为 28 岁，22 例（54%）为女性。8 例（19.5%）患者为 A 组，33 例（80.5%）为 B 组。B 组患者的病程更短（7 天 vs 30 天；p=0.01），更频繁地出现呕吐[25 例（75.7%） vs 2 例（25%）；p=0.01]和视盘水肿[13 例（39%） vs 0 例（0%）；p=0.04]。危险因素相似。MRI 显示 A 组双侧丘脑[5 例（62.5%） vs 6 例（18.2%）]和基底节[4 例（50%） vs 6 例（18.2%）]病变更常见。1 个月时，B 组有 2 例（6%）患者死亡，A 组无死亡，24 例患者预后良好（A 组 50%，B 组 60.6%）。3 个月时，30 例患者预后良好（A 组 62.5%，B 组 80.6%）。3 个月后改善不明显。