Cantú C, Barinagarrementeria F
Stroke Clinic, National Institute of Neurology and Neurosurgery, Mexico City, DF, Mexico.
Stroke. 1993 Dec;24(12):1880-4. doi: 10.1161/01.str.24.12.1880.
Cerebral venous thrombosis is characterized by its clinical pleomorphism and pathogenetic variability. We studied 67 patients with cerebral venous thrombosis associated with pregnancy and puerperium and compared them with 46 other cases unrelated to obstetric causes to disclose differences in their clinical presentation, neuroradiological findings, clinical course, and prognosis.
In this retrospective study, we analyzed the clinical, laboratory, and neuroimaging findings of 113 patients collected consecutively at our institute. The diagnosis of cerebral venous thrombosis was confirmed by angiography, magnetic resonance imaging, or neuropathological study.
Patients with cerebral venous thrombosis associated with pregnancy and puerperium were younger (average age, 26 versus 36 years), and in most, the onset of symptoms was acute (82% versus 54%; P = .003). The evolution of symptoms reached a plateau within 10 days in 70% of patients with thrombosis from obstetric causes, compared with only 45% in those from other causes (P = .01). Anemia was more frequent in the obstetric group (64% versus 26%; P = .00001). There were no differences regarding neurological and neuroradiological findings. Although the initial severity of illness was similar in both groups, the final outcome was considered good in 80% of patients with obstetric causes, compared with 58% of patients with other causes (P = .01); mortality rates were 9% and 33%, respectively (P = .002).
Cerebral venous thrombosis associated with pregnancy and puerperium has a more acute onset and a better prognosis than thrombosis due to other causes. These findings might be helpful in the diagnostic and therapeutic strategies for patients with cerebral venous thrombosis.
脑静脉血栓形成具有临床多态性和发病机制变异性的特点。我们研究了67例与妊娠和产褥期相关的脑静脉血栓形成患者，并将其与46例其他非产科原因的病例进行比较，以揭示它们在临床表现、神经影像学表现、临床病程和预后方面的差异。
在这项回顾性研究中，我们分析了在我们研究所连续收集的113例患者的临床、实验室和神经影像学检查结果。脑静脉血栓形成的诊断通过血管造影、磁共振成像或神经病理学研究得以证实。
与妊娠和产褥期相关的脑静脉血栓形成患者更年轻（平均年龄，26岁对36岁），并且大多数患者症状起病急（82%对54%；P = 0.003）。70%的产科原因血栓形成患者症状在10天内达到平稳期相比，其他原因患者仅为45%（P = 0.01）。产科组贫血更为常见（64%对26%；P = 0.00001）。在神经学和神经影像学表现方面没有差异。尽管两组最初的疾病严重程度相似，但产科原因患者最终结局良好的比例为80%，而其他原因患者为58%（P = 0.01）；死亡率分别为9%和33%（P = 0.002）。
与妊娠和产褥期相关的脑静脉血栓形成比其他原因导致的血栓形成起病更急，预后更好。这些发现可能有助于脑静脉血栓形成患者的诊断和治疗策略。
