摘要
Abstract
Objective To investigate the clinical characteristics of patients with cerebral venous sinus thrombosis and visual disorders as main manifestations, so as to provide a new thought for diagnosis and treatment. Methods The clinical data of 34 patients with venous sinus thrombosis and visual impairment as the manifestation who were admitted into the department of Neurology in Tongren hospital during Jan. 2004 to July 2016 were collected. The demographic data, clinical manifestations, laboratory tests and imaging characteristics were analyzed and summarized. Results Among 34 patients, 18 (52.9%) were male and 16 (47.1%) were female, with mean age of (36.1±12.9) year-old.There were 11 cases (32.4%) with sub-acute onset and 23 cases (67.6%) with chronic onset.There were 5 cases (14.7%) caused by infection, and other 29 cases (85.3%) caused by no-infection. Visual disturbance (n=29, 85.3%) and headache (n=9, 26.5%) were the first common clinical sign. Impaired vision included binocular vision loss (n=23), monocular vision loss (n=6),paroxysmal amaurosis (n=8, 23.5%), and 1 (2.9%) diplopia. Other accompanied symptoms were 9 cases of headache, 1 case of eye pain, 1 case of neck pain, 1 case of tinnitus, 1 case of dizziness and 2 cases of symptomatic epilepsy. The main sign of 29 cases was optic disc edema, including both eyes in 27 cases and one eye in 2 cases. Severe visual field defect means diffuse visual field defect or whole visual field defect. There were 18 (52.9%) cases which had severe visual field defect, including both eyes in 11 cases (32.4%) and one eye in 7 cases (20.6%). Lumbar puncture were performed in 33 cases. There were 1 case (3.0%) of intracranial pressure less than 180 mm H2O, 14 cases (42.4%) of 180-300 mm H2O, and 18 cases (54.5%) more than 330 mm H2O. All 34 patients underwent neuroimaging. The data showed that there were 7 cases (20.6%) with 1 cerebral venous thrombosis and 26 cases (76.5%) with more than 1 cerebral venous thrombosis.There were 12 cases (35.3%) who had brain lesion or dural lesion, and 22 cases (64.7%) who had no brain lesion. Conclusion Venous sinus thrombosis with visual impairment as the main manifestation mainly occurs young adults and most cases don't have explicit causes.Intracranial hypertension is the most common clinical manifestation.In addition, about half of cases had severe static vision field loss. Neuroimaging showed that the most common affected sites were sigmoid sinus and bilateral transverse sinus. Most cases had more than one site of thrombosis and no brain lesion.关键词
静脉窦血栓形成/视力障碍/神经影像Key words
Venous sinus thrombosis/Visual disturbance/Neuroimaging
