Clinical analysis of 68 patients with cerebral venous sinus thrombosis

Objective To investigate the clinical presentations, pathogenic factors, treatment and prognosis of the 68 patients with cerebral venous sinus thrombosis. Methods The clinical data of 68 patients' diagnosis of cerebral venous sinus thrombosis from January 2011 to May 2018 was collected and analyzed retrospectively. Results Sixty-eight patients (30 male,38 female), were recorded with mean age of (35.5±12.4) year-old. Forty-seven out of 68 cases had causes with pregnancy, puerperium, and Long-term drinking, autoimmune disease et al. Headache attack (58 cases, 85.3%) is the most common first clinical sign. Neuroimaging data showed that there were 54 cases (79.4%) with more than one cerebral venous thrombosis, only 14 cases (20.6%) had brain lesion. Thrombosis occurred most frequently in the order of lateral sinus in 106 cases, superior sagittal sinus thrombosis in 30 cases, straight sinus thrombosis in 12 cases, 2 case of deep vein and 4 cases involving internal jugular vein. Sixty-four patients (97.0%) had increased intracranial pressure, and 38 patients (57.6%) had greater than 300 mm H₂O(1 mm H₂O=9.8 Pa). Only 26 of 68 patients (38.2%) had elevated D-dimer. The patients in our group received good prognosis after anticoagulation, partial combination of intravenous sinus thrombolysis and stenting, and 6 of them relapsed in follow-up and relieved after retreatment. Conclusions Cerebral venous sinus thrombosis mainly affects young female adults and headache attack is the most common first clinical sign. Neuroimaging shows that most common affected sites are lateral sinus and superior sagittal sinus. Most cases have more than one site of thrombosis, and have intracranial hypertension and no brain lesion. The diagnosis cannot be ruled out if D-dimer is normal. Most patients get good prognosis after active treatment.