Abstract:
The evolution of the Coronavirus Disease-2019 pandemic and its vaccination raised more attention to cerebral venous thrombosis (CVT). Although CVT is less prevalent than arterial stroke, it results in larger years of life lost. CVT is more common in women and young patients. Predisposing factors are categorized as transient factors such as pregnancy, puerperium, oral contraceptive pills, trauma, and dehydration; and permanent factors such as neoplastic, vasculitic, thrombophilic, hematologic conditions, infectious causes such as severe acute respiratory syndrome coronavirus-2 infection and HIV. The most common manifestations are headache, seizures, focal neurologic deficits, altered level of consciousness, and cranial nerve palsies. The most common syndromes are stroke-like, raised-intracranial-pressure (ICP), isolated-headache, and encephalopathy, which may have overlaps. Diagnosis is mostly based on computed tomography, magnetic resonance imaging, and their respective venous sequences, supported by blood results abnormalities such as D-dimer elevation. Treatment includes the prevention of propagation of current thrombus with anticoagulation (heparin, or low molecular weight heparinoids and then warfarin, or direct oral anticoagulants), decreasing ICP (even by decompressive craniotomy), and treatment of specific underlying diseases.
摘要:
2019年冠状病毒病流行的演变及其疫苗接种引起了人们对脑静脉血栓形成(CVT)的更多关注。尽管CVT不如动脉中风流行,它导致更长的生命损失。CVT在女性和年轻患者中更为常见。诱发因素被归类为短暂因素,如怀孕,产褥期,口服避孕药,创伤,和脱水;和永久性因素,如肿瘤,血管,有血栓性,血液学状况,传染性原因,如严重急性呼吸道综合症冠状病毒-2感染和艾滋病毒。最常见的表现是头痛,癫痫发作,局灶性神经功能缺损,意识水平的改变,和颅神经麻痹。最常见的综合征是中风样,颅内压升高(ICP),孤立性头痛,和脑病,可能有重叠。诊断主要基于计算机断层扫描,磁共振成像,以及它们各自的静脉序列,支持血液结果异常,如D-二聚体升高。治疗包括通过抗凝(肝素,或者低分子量类肝素,然后华法林,或直接口服抗凝剂),降低ICP(甚至通过开颅减压术),和治疗特定的潜在疾病。