目的 探讨本病的病因、临床表现、影像学特征、治疗方法。方法 回顾性分析1例以反复孤立性头痛为主要表现的颅内静脉窦血栓病例,并复习相关文献。结果 患者男性,28岁,主因头痛10天,加重4天入院。头部MRI平扫+增强提示左侧乙状窦及横窦充盈缺损,T1及Flair呈高信号。数字减影血管造影证实为左侧横窦、乙状窦血栓。经抗感染及抗凝治疗后恢复良好。搜集近5年资料较完整的颅内静脉窦血栓病例145例,最常见的表现为头痛伴神经系统局灶性缺损症状,最常见的发病因素为高同型半胱氨酸血症,最常见的发病部位为上矢状窦及横窦。结论 颅内静脉窦血栓常表现为头痛、视力下降、肢体无力、癫痫、意识障碍等症状,仅少数表现为单纯性头痛。抗凝治疗结合血管介入治疗可有效改善患者预后。对于急性单发的反复性进行性加重的头痛患者需引起高度注意,避免漏诊产生不良后果。

Objective To explore the etiology, clinical features, imaging characteristics and therapeutic regimen of cerebral venous sinus thrombosis (CVST). Methods One case of CVST mainly featured with isolated headache was retrospective analyzed, and related literature was reviewed. Results A 28-year-old male patient was admitted to the hospital with a 10-day headache and aggravated for 4 days. Magnetic resonance imaging (MRI) plain scan and enhancement of the head indicated filling defect of the left sigmoid and transverse sinuses, T1 and Flair showed high signal. The thrombosis of left transverse sinus and sigmoid sinus was confirmed by digital subtraction angiography (DSA). The patient recovered well after anti-infection and anticoagulant treatment. A total of 145 CVST patients with complete data in recent 5 years were collected, the most common features, pathogenic factor, disease location were headache accompanied by focal impairment symptom of neurologic system, hyperhomocysteinemia, superior sagittal sinus (SSS) and transverse sinus, respectively.Conclusion CVST patients normally exhibit the symptoms including the headache, hypopsia, limb weakness, epilepsy and disturbance of consciousness, only a few show simple headache. Anticoagulant therapy with vascular intervention is effectively capable of improving the prognosis of CVST patients. It is necessary to pay high attention to the patients with acute single recurrent progressive headache to avoid missed diagnosis and adverse consequences.