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目的:研究围生期颅内静脉窦血栓形成的临床和影像学特征。方法:对13例围生期颅内静脉窦血栓形成患者的临床及影像学特点进行分析。结果与结论:13例均有头痛和视乳头水肿,发热8例,呕吐7例,肢体运动障碍7例,肢体偏瘫5例。6例行头颅CT检查,均发现脑实质内多发低密度影,但均未能显示CVST的直接征象---空三角征。13例行MRI,能明确静脉窦内有异常信号影6例,此6例中增强扫描后呈空三角征5例(此5例可确诊CVST);13例均可见较有诊断价值的静脉性脑梗死征象。13例行磁共振静脉成像(magnetic resonance venography,MRV),均能显示CVST病灶的静脉窦狭窄、闭塞或者充盈缺损。所有病例均予低分子肝素抗凝及脱水等对症治疗,全部治愈。对于围生期出现颅内压增高表现伴或不伴肢体运动障碍、肢体瘫痪等症状的患者首先应想到CVST,及时行MRI及MRV以作出诊断,给予低分子量肝素等治疗,可以提高治愈率。
Objective: To study the clinical and imaging features of perinatal intracranial venous sinus thrombosis. Methods: Clinical and imaging features of 13 patients with perinatal intracranial venous sinus thrombosis were analyzed. RESULTS AND CONCLUSION: All 13 cases had headache and papilledema. There were 8 cases of fever, 7 cases of vomiting, 7 cases of limb movement disorders and 5 cases of hemiplegia. 6 routine skull CT examination, were found within the brain parenchyma, multiple low-density, but failed to show the direct signs of CVST --- empty triangle sign. 13 cases of MRI, can identify abnormal signals within the sinus of 6 cases, 6 cases of enhanced scanning showed empty triangle in 5 cases (5 cases can be diagnosed CVST); 13 cases were more diagnostic value of venous Signs of cerebral infarction. 13 cases of magnetic resonance venography (magnetic resonance venography, MRV), can show the CVST lesion sinus stenosis, occlusion or filling defect. All cases were low molecular weight heparin anticoagulant and dehydration symptomatic treatment, all cured. For perinatal emergence of increased intracranial pressure performance with or without limb movement disorders, limb paralysis and other symptoms of patients should first think of CVST, timely MRI and MRV to make the diagnosis, given low molecular weight heparin and other treatments, can improve the cure rate.