OVERVIEW
OVERVIEW
Intracranial venous sinus thrombosis is a group of ischemic cerebrovascular diseases caused by a variety of etiologies, including intracranial venous sinus and venous thrombosis. Clinical symptoms vary depending on the cause and location of the lesion.
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Department
Neurology, Neurosurgery
Synonyms
Intracranial venous sinus and vein thrombosis
Clinical Symptoms
Headache, vomiting, impaired consciousness, seizures, neurologic deficits, etc.
Hazards
Impaired consciousness, seizures, neurological deficit, emergency situation, severe life-threatening.
Examination
CT, MRI, angiography, etc.
Diagnosis
Diagnosis can be made based on the clinical manifestations of increased intracranial pressure, impaired consciousness, epileptic seizure, neurological deficit, etc., combined with CT, MRI and other relevant examinations.
Treatment principle
Anticoagulation, symptomatic treatment, treatment of primary disease.
Curability
The overall prognosis is good after active treatment, and the mortality rate is not more than 10%.
Dietary advice
Give a light, easy-to-digest, high-protein, high-calorie, high-vitamin diet and strengthen nutritional support.
Etiology
Epidemiology
It occurs in the elderly and puerperal women.
Etiology
The cause of idiopathic disease is not known, while secondary disease is mostly related to infection, puerperium, dehydration, malnutrition and other factors.
Symptoms and Diagnosis
Typical symptoms
Depending on the cause of the disease, the location of the disease, and the rate of thrombosis, there is a wide variety of clinical manifestations. Typical symptoms include increased intracranial pressure with severe headache and projectile vomiting, seizures, impaired consciousness and neurological deficits.
Diagnosis
Acute or subacute onset with or without impaired consciousness. Clinical manifestations are diverse, mainly headache, vomiting, consciousness disorder, seizures, neurological deficits. Cranial CT suggests thrombosis of intracranial venous system; MRI shows poor visualization of intracranial venous sinus. Cranial angiography shows occlusion of the main trunk of the venous sinus, which is the gold standard for diagnosing intracranial venous thrombosis.
Treatment
Treatment guidelines
Anticoagulation, symptomatic treatment, treatment of primary disease.
Drug therapy
Anticoagulant therapy includes intravenous infusion of ordinary heparin or low molecular heparin anticoagulant, and intravenous or local thrombolytic therapy with urokinase. Lowering intracranial pressure is commonly done with mannitol or furosemide intravenously. Symptomatic drug treatment of convulsions or with seizures, should be given sedative drugs, such as diazepam, phenobarbital sodium. Protection of brain cells drugs such as cytarabine, cerebral vasculin, etc..
Other treatments
Symptomatic treatment to improve cerebral hypoxia, prevention of infection, correction of water and electrolyte disorders, life support therapy, etc. Treatment of the primary disease is directed at both inflammatory and non-inflammatory diseases.
Prognosis
If actively treated, the overall prognosis is good, with a mortality rate of no more than 10%.
Nursing care
Daily care
Rest in bed, avoid exertion, and relax. If the patient has convulsions or epileptic seizures, nursing care should be strengthened; if the patient is unconscious or has impaired limb movement, he/she should be helped to change the body position frequently to prevent pressure sores on the skin. Closely observe the patient’s vital signs, changes in condition, if abnormal, timely follow-up.
Dietary management
Give light, easy to digest, high protein, high calorie, high vitamin diet, and strengthen nutritional support.