颅内静脉窦血栓形成合并脑出血1例并文献复习

A Case of Cerebral Venous Sinus Thrombosis with Cerebral Hemorrhage and Literature Review

摘要: 目的：探讨颅内静脉窦血栓形成合并脑出血的临床特点及诊疗过程。方法：选取2024年10月青岛大学附属医院收治的颅内静脉窦血栓形成患者1例，回顾分析临床、实验室资料，并复习既往相关文献。结果：32岁女性患者因“头痛3天，意识障碍1天”入院，急诊行数字血管造影(DSA)取栓治疗，患者合并脑出血，后续颅内压增高，行颅内血肿清除术 + 去骨瓣减压术。患者病情好转后3个月行颅骨修补术 + 腰大池引流术，复查相关影像学检测示颅内静脉窦血栓消失。结论：服用性激素类药物育龄期妇女，出现头痛、意识障碍、癫痫等临床表现，需要警惕颅内静脉窦血栓形成可能。在治疗过程中，患者可能有梗死后出血情况发生，需密切关注症状体征的变化，及时针对引起病情变化的病因予以治疗。

Abstract: Objective: To investigate the clinical features, diagnosis, and treatment of cerebral venous sinus thrombosis (CVST) complicated with cerebral hemorrhage. Methods: A patient with cerebral venous sinus thrombosis admitted to the Affiliated Hospital of Qingdao University in October 2024 was selected. The clinical and laboratory data were retrospectively analyzed, and the previous relevant literature was reviewed. Results: A 32-year-old female patient was admitted to the hospital due to a headache for 3 days and disturbance of consciousness for 1 day. Emergency digital subtraction angiography (DSA) thrombectomy was performed for the patient with cerebral hemorrhage, and the subsequent increased intracranial pressure was treated with intracranial hematoma evacuation and decompressive craniectomy. Cranioplasty and lumbar drainage were performed 3 months after the patient’s condition improved, and the relevant imaging examination showed that the cerebral venous sinus thrombosis had disappeared. Conclusion: Women of childbearing age who take sex hormone drugs and have clinical manifestations such as headache, disturbance of consciousness, and epilepsy should be alert to the possibility of cerebral venous sinus thrombosis. During the treatment, patients may have post-infarction hemorrhage, so it is necessary to pay close attention to the changes in symptoms and signs and treat the causes of the changes in the condition in time.