Alam Harris, Curtis Dru, Aftab Syed A
Radiology, Florida State University College of Medicine, Orlando, USA.
Radiology, AdventHealth Orlando, Orlando, USA.
Cureus. 2024 Nov 14;16(11):e73693. doi: 10.7759/cureus.73693. eCollection 2024 Nov.
Dural venous sinus thrombosis, a subset of cerebral venous thrombosis, is an important pathology due to its significant morbidity and mortality. This process has an annual incidence of three to five cases per million adults. Although copious predisposing factors exist, the core principles revolve around Virchow's triad: venous stasis, hypercoagulability, and vascular endothelial damage. There are various risk factors related to unfavorable outcomes, which include female sex, intracranial hemorrhage, infection, cancer, and more. Trauma tends to be a risk factor, particularly in pediatric populations, as in this patient's case. Initial diagnosis in the acute setting commonly involves non-contrast CT studies to exclude hemorrhage. In subacute or chronic settings, MRI can be utilized. Anticoagulation remains the mainstay of therapy for treatment, along with treating any underlying causes of thrombosis. We present a pediatric patient with extensive post-traumatic dural venous sinus thromboses with classic imaging findings as well as full resolution of clinical symptoms after this pathologic process was recognized and treated appropriately.
硬脑膜静脉窦血栓形成是脑静脉血栓形成的一个子集,因其显著的发病率和死亡率而成为一种重要的病理情况。这一过程的年发病率为每百万成年人中有三至五例。尽管存在大量的诱发因素,但其核心原则围绕着维勒三联征:静脉淤滞、高凝状态和血管内皮损伤。存在各种与不良预后相关的危险因素,包括女性、颅内出血、感染、癌症等等。创伤往往是一个危险因素,特别是在儿科人群中,就像该患者的情况一样。急性情况下的初始诊断通常涉及非增强CT检查以排除出血。在亚急性或慢性情况下,可以使用MRI。抗凝治疗仍然是主要的治疗方法,同时要治疗血栓形成的任何潜在原因。我们介绍了一名患有广泛创伤后硬脑膜静脉窦血栓形成的儿科患者,其具有典型的影像学表现,并且在该病理过程得到识别和适当治疗后临床症状完全缓解。