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Cerebral venous thrombosis: a practical guide.
Practical Neurology Pub Date : 2020-08-29 , DOI: 10.1136/practneurol-2020-002415
Leonardo Ulivi,Martina Squitieri,Hannah Cohen,Peter Cowley,David J Werring

All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). It is difficult to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations (different from ‘conventional’ stroke, and often mimicking other acute neurological conditions), and because it is often challenging to obtain and interpret optimal and timely brain imaging. Although CVT can result in death or permanent disability, it generally has a favourable prognosis if diagnosed and treated early. Neurologists involved in stroke care therefore also need to be aware of the treatments for CVT (with varying degrees of supporting evidence): the mainstay is prompt anticoagulation but patients who deteriorate despite treatment can be considered for endovascular procedures (endovascular thrombolysis or thrombectomy) or neurosurgery (decompressive craniotomy). This review summarises current knowledge on the risk factors, diagnosis, treatment and prognosis of CVT in adults, and highlights some areas for future research.

中文翻译:

脑静脉血栓形成:实用指南。

所有神经科医生都需要能够识别和治疗脑静脉血栓形成(CVT)。很难诊断,部分是由于其相对稀少,其多种多样的临床表现(不同于“常规”中风,并且常常模仿其他急性神经系统疾病),并且因为获取和解释最佳及时的大脑通常具有挑战性成像。尽管CVT可以导致死亡或永久性残疾,但如果及早诊断和治疗,通常预后良好。因此,参与卒中治疗的神经科医生也需要了解CVT的治疗方法(有不同程度的支持证据):主要的治疗手段是迅速的抗凝治疗,但是尽管治疗仍然恶化的患者可以考虑进行血管内手术(血管内溶栓或血栓切除术)或神经外科手术(减压开颅手术)。这篇综述总结了关于成人CVT的危险因素,诊断,治疗和预后的最新知识,并重点介绍了一些需要进一步研究的领域。
更新日期:2020-08-29
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