目的总结大脑大静脉与直窦血栓形成的早期诊断和治疗方法。方法回顾性总结本院收治的18例大脑大静脉与直窦血栓形成的临床表现、实验室资料、脑脊液检查、影像学特征、治疗经过和预后,并结合文献进行回顾性分析。结果10例患者为急性起病,5例为亚急性起病,3例慢性起病。主要临床表现为头痛、呕吐、视乳头水肿、癫痫、意识障碍,局灶性神经功能障碍。腰穿显示16例患者颅压明显升高。影像学检查提示,18例患者均有异常征象,其中3例合并上矢窦,2例合并海绵窦血栓形成。上述患者予以应用脱水、抗凝、局部溶栓及对症治疗,死亡2例,痊愈16例。结论大脑大静脉与直窦血栓形成表现多样,多伴颅内压增高。及时影像学检查有助于早期诊断。治疗以降颅内压和抗凝治疗为首选。 Objective To summarize the early diagnosis and treatment of cerebral vein and straight sinus thrombosis. Methods The clinical manifestations, laboratory data, cerebrospinal fluid (CSF) examination, imaging features, treatment and prognosis of 18 cases of large cerebral vein and straight sinus treated in our hospital were retrospectively reviewed. The retrospective analysis was made based on the literature. Results Ten patients had acute onset, five had subacute onset and three had chronic onset. The main clinical manifestations of headache, vomiting, papilledema, epilepsy, disturbance of consciousness, focal neurological dysfunction. Waist wear showed significant increase in intracranial pressure in 16 patients. Imaging examination showed that 18 patients had abnormal signs, of which 3 cases were combined on the sinuses, 2 cases of cavernous sinus thrombosis. The above patients were applied dehydration, anticoagulation, local thrombolysis and symptomatic treatment, 2 patients died, 16 cases were cured. Conclusion Cerebral venules and straight sinus thrombosis varied, with increased intracranial pressure. Timely imaging help to early diagnosis. Treatment to reduce intracranial pressure and anticoagulant therapy is preferred.