脑静脉血栓(2017)

重要的解剖与临床
Clinically patients with cerebral venous thrombosis present with variable symptoms ranging from headache to seizure and coma in severe cases.头痛、癫痫、昏迷。 In neonates shock and dehydration is a common cause of venous thrombosis. 新生儿休克或脱水是常见的原因。 In older children it is often local infection, such as mastoiditis, or coagulopathy.局灶性感染，如中耳炎或凝血障碍。 In adults, coagulopathies is the cause in 70% and infection is the cause in 10% of cases.成人70%病因为凝血障碍；10%源自感染。 In women, oral contraceptive use and pregnancy are strong risk factors.女性，口服避孕药与妊娠是危险因素。
脑静脉血栓
Cerebral Venous Thrombosis
Barbara Simons, Geert Lycklama a Nijeholt and Robin Smithuis Radiology department of the Medical Centre Haaglanden in the Hague and the Rijnland hospital in Leiderdorp, the Netherlands
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2017-1月杨景震 整理制作
•Introduction •When to think of venous thrombosis • Dense clot sign • Empty delta sign • Absence of normal flow void on MR • Venous infarction •Imaging in suspected thrombosis • CT-venography • MR-venography • DSA •Pitfalls in CT • Arachnoid Granulations • Mimick of dense clot sign • Pseudo empty delta sign • Wrong bolus timing •Pitfalls in MRI • Hypoplastic transverse sinus • Low signal intensity in thrombus • Flow void on contrast-enhanced MR •Chronic dural sinus thrombosis and related syndromes • DAVF • Thrombosis and increased CSF pressure •Venous territories
Publicationdate October 21, 2010 Cerebral venous thrombosis is an important cause of stroke especially in children and young adults. It is more common than previously thought and frequently missed on initial imaging. It is a difficult diagnosis because of its nonspecific clinical presentation and subtle imaging findings. In this article we will focus on: • Findings on routine imaging that should make you think of unsuspected venous thrombosis. • How to image patients in suspected venous thrombosis. • Pitfalls.
Hale Waihona Puke When to think of venous thrombosis Venous thrombosis has a nonspecific presentation and therefore it is important to recognize subtle imaging findings and indirect signs that may indicate the presence of thrombosis. Although these findings are often present on initial scans, they are frequently detected only in retrospect. Clinically patients with venous thrombosis often present with seizures, which is not a symptom in patients with an arterial infarction.
Cerebral venous thrombosis is located in descending order in the following venous structures: • Major dural sinuses: Superior sagittal sinus, transverse, straight and sigmoid sinuses. • Cortical veins: • Vein of Labbe, which drains the temporal lobe. • Vein of Trolard, which is the largest cortical vein that drains into the superior sagittal sinus. • Deep veins: Internal cerebral and thalamostriate veins. • Cavernous sinus.