颅内静脉血栓形成.ppt
**************************************************************************●介入治疗◆经皮股静脉穿刺溶栓法◆经颈静脉穿刺溶栓法◆经颅骨静脉窦插管溶栓法◆经前囟穿刺溶栓法◆微套圈辅助的直接溶栓法◆颈动脉穿刺溶栓法◆微球囊经皮腔内血管成形术脑静脉系血栓形成治疗第64页,共67页,2024年2月25日,星期天●外科手术◆静脉窦切开血栓清除术◆静脉窦内插管溶栓术◆Sindou横窦搭桥术◆静脉窦修补术◆Donaphy静脉窦修补术脑静脉系血栓形成治疗第65页,共67页,2024年2月25日,星期天◆CVT预后差异较大,可预测性差,部分预后较好,癫痫发作及病情复发率均较低。◆近期Bruijn在对59例脑静脉窦血栓患者进行了前瞻性研究后提出如果存在昏迷、颅内出血,则预后不良。脑静脉系血栓形成预后第66页,共67页,2024年2月25日,星期天*感谢大家观看第67页,共67页,2024年2月25日,星期天********************************************************脑静脉窦血栓上矢状窦血栓(superiorsagittalsinusthrombosis,SSST)This58year-oldmancomplainedofasevereheadache12hoursaftertakingpartintheLondonmarathon.Heattendedthegeneralcasualtybutnocausewasfound.Hewasdischargedwithadiagnosisofpossiblemigraine.However,thepainpersistedandhere-attendedthecasualty2dayslater.HewasfoundtohavebilateralopticdiscswellingsandanurgentMRIscanwasrequested.Fullbloodcountrevealedhighplateletcount(thrombocythemia)butotherwisealltheothertestswerenormal第32页,共67页,2024年2月25日,星期天脑静脉窦血栓上矢状窦血栓(superiorsagittalsinusthrombosis,SSST)ClinicalHistory:17-year-oldfemalewhopresentswithafourdayhistoryofheadachesandaseizureimmediatelypriortoadmission.Thereisnosignificantpastmedicalhistory.Findings:AnaxialnoncontrastedCTimagethroughthebraindemonstratescerebraledemawithintheleftfrontallobeanddeepgraymatter.Inaddition,thereishyperattenuationwithintheregionofthestraightsinus.PetechialhemorrhageaswellasedemaisseenwithintheleftfrontallobeAnangiogramdemonstratesocclusionoftheanterioronehalfofthesuperiorsagittalsinusaswellasocclusionofthedeepvenoussystembilaterally.