头痛等特征对颅内静脉窦血栓形成早期诊断意义

IMPORTANCE OF HEADACHE AND OTHER SYNDROMES ON EARLY DIAGNOSIS OF CEREBRAL VENOUS SINUS THROMBOSIS

摘要:

目的:分析1月内和1月后确诊为颅内静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)病例的不同临床特点,以提高CVST早期诊断率。方法:分析86例经DSA证实为CVST的病例特点。根据患者确诊所用的时间,将患者分为A组:1月内确诊组(n=37)和B组:1月后确诊组(n=49)。结果:A组头痛评分较B组显著增高(P<0.01);A组有诱因、呕吐和肢体瘫痪的病例较B组显著增多(P<0.01);A组有视物模糊的病例较B组显著减少(P<0.01);A组MRI检查发现CVST直接征象的病例较B组显著增多(P<0.01)。结论:头痛程度重,有诱因、呕吐、肢体瘫痪和MRI检查发现直接征象的病例容易得到早期诊断;反之,头痛程度轻,无诱因、呕吐、肢体瘫痪和MRI检查未发现直接征象的患者容易导致延误诊断,延误诊断的患者容易出现视物模糊。

Abstract:

Objective:To describe the clinical features of cerebral venous sinus thrombosis(CVST) diagnosed before and after one month.Methods:86 CVST patients confirmed by DSA were recruited for investigation.These patients were divided into two groups according to the time of the final diagnosis.Results:The headache scores in group A were higher than those in group B(P<0.01);vomiting,paralysis and inducement were more frequently seen in group A than those in group B(P<0.01);blurred vision was less frequently seen in group A than those in group B.There were more direct signs on MRI in group A than those in group B.Conclusion:The early diagnosis of CVST is easily made in patients with severe headache,vomiting,paralysis,inducement and direct signs on MRI.On the contrary,the diagnosis of CVST is frequently delayed in patients without severe headache,vomiting,paralysis,inducement and direct signs on MRI.Blurred vision is a common symptom in patients without early diagnosis.