脑静脉窦血栓形成1例并文献复习

A Case Report of Cerebral Venous Sinus Thrombosis and Literature Review

摘要: 脑静脉窦血栓形成(Cerebral venous sinus thrombosis, CVST)是脑血管疾病的一种表现形式，具有高危性、高致死性的特点，目前正趋于年轻化，其临床发病率较低，发病机制复杂，临床表现多种多样，诊断难度较大，因此本文通过报道1例静脉性脑梗死患者的临床诊疗经过，并回顾相关文献报道，总结疾病特点，提高对该病的认识及诊断水平。本例患者为28岁的年轻女性，发病前4周有生产病史，临床表现主要为左侧肢体活动不灵，症状逐渐加重，后出现癫痫发作，检验结果示：D2-聚体升高明显，检查结果头颅MRI显示T1等、T2高异常信号，扩散加权成像DWI呈明显高信号，颅脑CTV提示上矢状窦节段性充盈缺损，诊断为静脉性脑梗死后经过积极抗凝及对症支持治疗，患者病情稳定，转入康复科进行肢体康复训练。

Abstract: Cerebral venous sinus thrombosis (CVST) is a manifestation of cerebrovascular disease, which has the characteristics of high risk and high fatality. At present, it tends to be younger, its clinical incidence is low, the pathogenesis is complex, the clinical manifestations are varied, and the diagnosis is difficult. Therefore, this paper reports the clinical diagnosis and treatment of a patient with venous cerebral infarction, reviews the relevant literature reports, and summarizes the characteristics of the disease, to improve the understanding and diagnosis of the disease. This patient is a 28-year-old young woman with a history of childbirth 4 weeks before the onset of the disease. The main clinical manifestations are dyskinesia of the left limb, gradual aggravation of symptoms, and epileptic seizures. The results showed that the D2-polymer increased significantly, and the head MRI showed T1 and T2 high signal intensity. Diffusion-weighted imaging DWI showed obvious high signal intensity. Brain CTV showed a segmental filling defect of the superior sagittal sinus. After active anticoagulation and symptomatic support treatment after the diagnosis of venous cerebral infarction, the patient’s condition was stable and transferred to the rehabilitation department for limb rehabilitation training.