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目的 本文报告 85例多发性脑静脉和静脉窦血栓的诊断和血管内溶栓治疗。方法 依MR影像在相应脑静脉窦区出现长T2 ,短T1信号和DSA显示脑静脉窦充盈缺损 ,及脑小静脉扩张迂曲和静脉期循环时间延长是血栓形成的根据。治疗中以间断穿刺颈动脉和静脉窦内留置微导管注入尿激酶为主 ,并辅以口服华法林抗凝。结果 1周后复查脑血管造影 ,5 / 18例静脉窦出现部分再通 ;8/ 18例脑循环时间接近正常 ,12例小静脉迂曲扩张现象明显改善。治疗 10d后 ,80例颅内压降至 2 30~30 0mmH2 O ;临床病情显著缓解 ,与脑血管造影基本符合。结论 本组资料表明 ,颈动脉内连续应用尿激酶溶栓并结合全身抗凝对治疗多发性脑静脉窦血栓可能是有效的方法之一
PURPOSE: This report reports the diagnosis and endovascular thrombolysis of 85 patients with multiple cerebral venous and sinus thrombosis. Methods According to MR images, long T2 and short T1 signals and DSA in the corresponding region of the cerebral venous sinus showed the filling defect of the cerebral venous sinus and the tortuous dilation of the vena cava and the prolonged venous circulation were the basis of thrombus formation. Intermittent puncture in the treatment of carotid and sinus venous microcirculation catheter urokinase-based, supplemented with oral warfarin anticoagulation. Results One week later, cerebrovascular angiography was retrospectively reviewed. A total of 5 of 18 sinusoids recanalized. The time of 8/18 cerebral circulation was close to normal, and the venous tortuosity of 12 cases was significantly improved. After 10 days of treatment, 80 cases of intracranial pressure dropped to 2 30 ~ 30 0mmH 2 O; clinical symptoms were significantly alleviated, and basically consistent with cerebral angiography. Conclusion The data in this group show that continuous administration of urokinase thrombolysis in combination with systemic anticoagulation in the carotid artery may be one of the effective ways to treat multiple cerebral venous sinus thrombosis