Jesuyajolu Damilola, Olukoya Olatomiwa, Moti Terngu
Department of Neurosurgery Association of Future African Neurosurgeons Yaounde Cameroon.
Department of Neurosurgery Surgery Interest Group of Africa Lagos Nigeria.
Clin Case Rep. 2022 Aug 3;10(8):e6200. doi: 10.1002/ccr3.6200. eCollection 2022 Aug.
Although the leading causes of subarachnoid hemorrhage (SAH) are aneurysm rupture and arteriovenous malformations, cerebral venous sinus thrombosis (CVST) can, in rare cases, be associated with SAH. This phenomenon is an uncommon presentation, with less than a hundred cases reported based on our review of the literature. The purpose of this review is to highlight what is known regarding these cases, how they are managed and to highlight the need for further studies that will serve as a basis for the development of a standard management guideline across board. The following databases were searched: PubMed and Ovid Embase. A complementary search of Google Scholar and AJOL was done. Gray literature search was also conducted on the Google search engine for any additional relevant papers. We were able to extract data regarding 33 cases from 29 identified studies. The mean age was 46.6 ± 14.08. 17 (51.5%) of the cases were female, and the female-to-male ratio is 1.1:1. Headache was by far the commonest symptom, occurring in 82% of cases followed by seizures in 42% of cases. Four patients (12%) had loss of consciousness while 5 patients (15%) had some form of focal neurologic deficit. Twenty patients had cerebral venous sinus thrombosis in at least two different sinuses. The superior sagittal sinus was the most common location for CVSTs (79%), followed by the transverse sinus (57.5%). Twenty-nine cases (89%) were managed with anticoagulation alone and one case had a mechanical thrombectomy. We have performed a comprehensive review of cases that had the simultaneous occurrence of SAH and CVST and have identified their peculiarities and the challenges to management. Further research is needed in order to identify a causal relationship and to serve as a basis for the development of a standard management guideline across the board.
虽然蛛网膜下腔出血（SAH）的主要原因是动脉瘤破裂和动静脉畸形，但在极少数情况下，脑静脉窦血栓形成（CVST）也可与SAH相关。这种现象并不常见，根据我们对文献的回顾，报告的病例不到100例。本综述的目的是强调关于这些病例的已知情况、治疗方法，并强调需要进一步研究，为制定全面的标准管理指南提供依据。我们检索了以下数据库：PubMed和Ovid Embase。还对谷歌学术和AJOL进行了补充检索。此外，在谷歌搜索引擎上进行了灰色文献检索，以查找任何其他相关论文。我们从29项已确定的研究中提取了33例病例的数据。平均年龄为46.6±14.08岁。其中17例（51.5%）为女性，男女比例为1.1:1。头痛是迄今为止最常见的症状，82%的病例出现头痛，其次是42%的病例出现癫痫发作。4例患者（12%）出现意识丧失，5例患者（15%）有某种形式的局灶性神经功能缺损。20例患者至少在两个不同的静脉窦出现脑静脉窦血栓形成。上矢状窦是CVST最常见的部位（79%），其次是横窦（57.5%）。29例（89%）仅采用抗凝治疗，1例进行了机械取栓术。我们对同时发生SAH和CVST的病例进行了全面综述，确定了它们的特点和治疗挑战。需要进一步研究以确定因果关系，并为制定全面的标准管理指南提供依据。
