Clinical and imaging features of patients with severe cerebral venous sinus thrombosis
10.3969/j.issn.1004-1648.2025.02.014
- VernacularTitle:重症脑静脉窦血栓形成患者的临床及影像学特点
- Author:
Jing ZHANG
1
;
Hanming GE
1
;
Gejuan ZHANG
1
Author Information
1. 710018 西北大学附属医院·西安市第三医院神经内科
- Publication Type:Journal Article
- Keywords:
severe cerebral venous sinus thrombosis;
clinical manifestations;
imaging features;
treatment strategy;
prognosis
- From:
Journal of Clinical Neurology
2025;38(2):116-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical and imaging features of patients with severe cerebral venous sinus thrombosis(CVST).Methods Consecutive severe CVST patients diagnosed at the Affiliated Hospital of Northwestern University(Xi'an NO.3 Hospital)from January 2017 to July 2024 were included.Patients'demographic characteristics,clinical manifestations,risk factors,imaging characteristics,onset mode,D-dimer levels,time from onset to diagnosis,treatment strategies,and prognosis were collected and recorded.Results A total of 17 severe CVST patients were included,of which 4 cases(23.5％)were male and 13 cases(76.5％)were female,with a male-to-female ratio of 1∶3.25.The median age was 41 years(range:19-56 years).The main clinical symptoms were headache,nausea and vomiting,seizures,focal neurological deficits,psychiatric symptoms,disturbance of consciousness,and limited neck mobility.The most common clinical symptoms were headache(15/17),seizures(7/17),and focal neurological deficits(7/17),followed by disturbance of consciousness(4/17).Among the 17 patients,10 cases(58.8％)had ischemic stroke and 9 cases(52.9％)had hemorrhagic stroke.The involvement rates of transverse sinus,superior sagittal sinus,sigmoid sinus,straight sinus and inferior sagittal sinus were 94.1％,64.7％,47.1％,29.4％and 11.8％respectively,and the proportion of patients with involvement of 2 or more venous sinuses reached 88.2％.Among the 17 patients,12 cases exhibited a lack of response to standard anticoagulation therapy and underwent endovascular therapy subsequently,and one of them had new intracranial hemorrhage.Two(11.8％)patients had poor prognosis at 90 d after discharge,with one patient death and one patient with an mRS score of 3.Fifteen patients(88.2％)had a good prognosis(3 cases with an mRS score of 2,5 cases with an mRS score of 1,and 7 cases with an mRS score of 0).Conclusions Severe CVST patients often present with seizures,impaired consciousness,involvement of multiple venous sinuses,ischemic stroke,and hemorrhagic stroke.Early identification,and active anticoagulation or endovascular therapy are crucial to improve the prognosis and reduce the disability and mortality rates of this disease.
