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成人颅内静脉血栓形成:来自一家三甲医院的 35 例病例系列研究。

Cerebral venous thrombosis in adults: a case series of 35 patients from a tertiary hospital.

机构信息

Unidad de Enfermedad Tromboembólica Venosa, Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.

Unidad de Enfermedad Tromboembólica Venosa, Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

出版信息

Rev Clin Esp (Barc). 2023 Aug-Sep;223(7):423-432. doi: 10.1016/j.rceng.2023.06.005. Epub 2023 Jun 19.

Abstract

OBJECTIVE

To describe the baseline characteristics, clinical presentation, imaging tests and outcomes, and identify potential prognostic factors in a cohort of patients diagnosed with cerebral venous thrombosis (CVT).

PATIENTS AND METHODS

This retrospective, single-center, observational study included adult patients diagnosed with CVT from January 2016 to December 2020. The variables were reviewed using electronic medical records.

RESULTS

A total of 35 patients were included, with a median age at diagnosis of 50.3 (+/- 17.8) years, and the majority being women (74.4%). Nearly 95% of the patients presented at least one risk factor for the development of CVT. Heparins were used for the acute phase in 97.1% of cases, with 75% of those being low molecular weight heparins.During the first two weeks, a compound event (death, intensive care unit admission, National Institute of Health Stroke Scale at discharge >3, CVT recurrence, major bleeding, or the presence of complications) occurred in 28.6% of patients (10 patients).Over the mean follow-up period of 3.3 years, 14.3% of the patients died (with only one death attributed to CVT), one patient experienced major bleeding, and no patients had a recurrence of CVT.

CONCLUSIONS

In our cohort, CVT predominantly affected young women with at least one risk factor for its development. The presence of edema on CT and corticosteroid treatment were associated with a poor short-term prognosis. However, we observed a favorable long-term prognosis in terms of mortality, recurrence, and bleeding.

摘要

目的

描述一组脑静脉血栓形成(CVT)患者的基线特征、临床表现、影像学检查结果和转归,并确定潜在的预后因素。

患者和方法

这是一项回顾性、单中心、观察性研究,纳入了 2016 年 1 月至 2020 年 12 月期间在我院确诊为 CVT 的成年患者。使用电子病历回顾变量。

结果

共纳入 35 例患者,中位诊断年龄为 50.3(+/-17.8)岁,大多数为女性(74.4%)。近 95%的患者至少存在一种 CVT 发生的危险因素。97.1%的患者在急性期使用肝素,其中 75%为低分子肝素。在最初的两周内,28.6%的患者(10 例)发生了复合事件(死亡、入住重症监护病房、出院时 NIHSS 评分>3、CVT 复发、大出血或存在并发症)。在平均 3.3 年的随访期间,14.3%的患者死亡(仅有 1 例死亡归因于 CVT),1 例患者发生大出血,无患者 CVT 复发。

结论

在我们的队列中,CVT 主要影响有至少一种发生风险因素的年轻女性。CT 上存在水肿和皮质类固醇治疗与短期不良预后相关。然而,我们观察到死亡率、复发率和出血率的长期预后良好。

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