Analysis on the clinical characteristics and treatment of intracranial venous and sinus thrombosis

Abstract

Objective To explore the clinical characteristics and treatment of intracranial venous and sinus thrombosis. Methods Fourteen patients (2 males and 12 females) with intracranial venous and sinus thrombosis were divided into 2 groups, and were treated with argatroban (argatroban group, n = 8) and heparin (heparin group, n = 6), respectively. Age, pattern of onset, clinical manifestations, imaging characteristics and result of cerebrospinal fluid (CSF) examination were analysed. The improvement of neural function and outcome was compared between 2 groups. Results Intracranial venous and sinus thrombosis could be seen in all age, but especially often occurred in young and middle⁃aged women. The common causes were pregnancy, infection, immunological disorders, etc. Acute or subacute clinical characteristics were headache (71.43%, 10/14), seizure (35.71%, 5/14), asthenia (21.43%, 3/14), and CSF pressure was significantly high in most patients. The imaging findings were cerebral venous and sinus occlusion and cerebral parenchymal impairment (infarction, hemorrhage, brain edema). There were 7 and 5 effective cases in argatroban group and heparin group, respectively (Z = ⁃ 0.067, P = 0.950). In both group, the neural function [National Institute of Health Stroke Scale (NIHSS) score] was significantly improved after treatment (P = 0.007). Conclusion Intracranial venous and sinus thrombosis should be highly suspected in patients who have no common risk factors for stroke, but with acute intracranial hypertensive symptoms such as headache, vomiting, and cortex symmetric infarction on CT scanning. Although cerebral angiography is the golden standard for the diagnosis of intracranial venous and sinus thrombosis, most patients can be early diagnosed by magnetic resonance imaging (MRI) and magnetic resonance venography (MRV). The difference in curative effect is not significant between argatroban and heparin. The patient with intracranial venous and sinus thrombosis may get more benefit, when anticoagulant therapy is given earlier and actively. DOI：10.3969/j.issn.1672-6731.2011.02.015