下载
加入VIP
  • 专属下载特权
  • 现金文档折扣购买
  • VIP免费专区
  • 千万文档免费下载

上传资料

关闭

关闭

关闭

封号提示

内容

首页 脑静脉血栓形成

脑静脉血栓形成.pdf

脑静脉血栓形成

查理
2011-03-05 0人阅读 举报 0 0 0 暂无简介

简介:本文档为《脑静脉血栓形成pdf》,可适用于教育、出版领域

HandbookonCerebralVenousThrombosisFrontiersofNeurologyandNeuroscienceVolSeriesEditorJBogousslavsky,MontreuxHandbookonCerebralVenousThrombosisBasel·Freiburg·Paris·London·NewYork·Bangalore·Bangkok·Singapore·Tokyo·SydneyVolumeEditorsVCaso,PerugiaGAgnelli,PerugiaMPaciaroni,Perugiafigures,incolor,andtables,DrValeriaCaso,MD,PhDProfGiancarloAgnelli,MDDrMaurizioPaciaroniStrokeUnitandDivisionofCardiovascularMedicineDepartmentofInternalMedicine,UniversityofPerugiaSantaMariadellaMisericordiaHospitalViaDottoriSant’AndreadelleFratteIT–PerugiaBibliographicIndicesThispublicationislistedinbibliographicservices,includingCurrentContents®andIndexMedicusDisclaimerThestatements,optionsanddatacontainedinthispublicationaresolelythoseoftheindividualauthorsandcontributorsandnotofthepublisherandtheeditor(s)Theappearanceofadvertisementsinthebookisnotawarranty,endorsement,orapprovaloftheproductsorservicesadvertisedoroftheireffectiveness,qualityorsafetyThepublisherandtheeditor(s)disclaimresponsibilityforanyinjurytopersonsorpropertyresultingfromanyideas,methods,instructionsorproductsreferredtointhecontentoradvertisementsDrugDosageTheauthorsandthepublisherhaveexertedeveryefforttoensurethatdrugselectionanddosagesetforthinthistextareinaccordwithcurrentrecommendationsandpracticeatthetimeofpublicationHowever,inviewofongoingresearch,changesingovernmentregulations,andtheconstantflowofinformationrelatingtodrugtherapyanddrugreactions,thereaderisurgedtocheckthepackageinsertforeachdrugforanychangeinindicationsanddosageandforaddedwarningsandprecautionsThisisparticularlyimportantwhentherecommendedagentisanewandorinfrequentlyemployeddrugAllrightsreservedNopartofthispublicationmaybetranslatedintootherlanguages,reproducedorutilizedinanyformorbyanymeanselectronicormechanical,includingphotocopying,recording,microcopying,orbyanyinformationstorageandretrievalsystem,withoutpermissioninwritingfromthepublisher©CopyrightbySKargerAG,POBox,CH–Basel(Switzerland)wwwkargercomPrintedinSwitzerlandonacidfreeandnonagingpaper(ISO)byReinhardtDruck,BaselISSN–ISBN––––LibraryofCongressCataloginginPublicationDataHandbookoncerebralvenousthrombosisvolumeeditors,VCaso,GAgnelli,MPaciaronipcm–(Frontiersofneurologyandneuroscience,ISSN–v)IncludesbibliographicalreferencesandindexesISBN––––(hardcover:alkpaper)SinusthrombosisICaso,V(Valeria)IIAgnelli,GiancarloIIIPaciaroni,M(Maurizio)IVSeriesDNLM:IntracranialThrombosis–diagnosisIntracranialThrombosis–radiotherapySinusThrombosis,Intracranial–diagnosisSinusThrombosis,Intracranial–radiotherapyWLHRCH�–dcVContentsIntroductionKappelle,LJ(Utrecht)AnatomyofCerebralVeinsandSinusesKlç,TAkakn,A(Istanbul)EpidemiologyofCerebralVeinandSinusThrombosisAgnelli,GVerso,M(Perugia)RiskFactorsofCerebralVeinandSinusThrombosisdeFreitas,GR(RiodeJaneiro)Bogousslavsky,J(Montreux)ThrombophiliaandCerebralVeinThrombosisIorio,A(Perugia)Barnes,C(Parkville)Vedovati,MC(Perugia)Favaloro,EJ(Westmead)ClinicalPresentationsofCerebralVeinandSinusThrombosisPaciaroni,MPalmerini,F(Perugia)Bogousslavsky,J(Montreux)HeadacheandCerebralVeinandSinusThrombosisAlberti,AVenti,MBiagini,S(Perugia)RadiologicalDiagnosisofCerebralVenousThrombosisSelim,MCaplan,LR(Boston,Mass)RoleofUltrasoundinDiagnosisandManagementofCerebralVeinandSinusThrombosisStolz,EP(Giessen)CerebralVenousThrombosisinNewborns,InfantsandChildrenYager,JYBlack,KBauman,MMassicotte,P(Edmonton,Alta)TreatmentofCerebralVenousandSinusThrombosisMasuhr,FEinhäupl,K(Berlin)InterventionalNeuroradiologyintheTreatmentofCerebralVenousThrombosisCaso,VBilleci,AMR(Perugia)Leys,D(Lille)ComplicationsofCerebralVeinandSinusThrombosisFerro,JMCanhão,P(Lisbon)LongTermPrognosisofCerebralVeinandSinusThrombosisLindgren,A(Lund)AuthorIndexSubjectIndexContentsVICasoV,AgnelliG,PaciaroniM(eds):HandbookonCerebralVenousThrombosisFrontNeurolNeurosciBasel,Karger,,vol,pp–IntroductionLJKappelleUniversityDepartmentofNeurology,UniversityMedicalCenterUtrecht,RudolphMagnusInstituteforNeurosciences,Utrecht,TheNetherlandsCerebralveinscontainaboutofthetotalcerebralbloodvolume,butcerebralvenoussinusthrombosis(CVST)occursaboutthousandtimeslessoftenthanarterialstrokeArterialandvenousstrokecausedifferentneurologicaldeficitsandoccurinpeopleofdifferentagesAbouthalfofthepatientswithanarterialstrokeareolderthanyears,whereasCVSTmostoftenaffectsyoungadultsandchildrenItisnotamanifestationofatherosclerosis,butusuallyisassociatedwithaprothromboticstatedueto(inherited)thrombophilia,otherblooddisorders,dehydration,infectiousdiseases,cancer,ormorerarecausesInaboutaquarterofthepatientswithCVSTthecauseremainsunknownTheannualincidenceiscurrentlyestimatedtobe–casespermillionpeopleThreeoutofpeoplewithCVSTarewomenOneoutofpatientswilldieorremainhandicappedasaresultofCVSTDuringthepastdecade,modernneuroimagingtechniqueshaveimprovedthediagnosticprocessandtogetherwiththeincreasedawarenessthiswillprobablyresultinincreasedrecognitioninthefutureCVSThasreceivedfarlessattentioninclinicalresearchthanarterialstrokeThesmallnumberofpatientswithCVSTlimitstheperformanceoflargeepidemiologicalstudiesandclinicaltrialsonascalesimilartothatinpatientswitharterialstrokeThelargesttrialinthefieldofCVSTcountedonlypatientsSofar,onlythreetrialshavebeenperformedtostudytreatmentwithanticoagulationAllthreetrialsshowedanonsignificantbenefitofanticoagulanttreatmentascomparedwithplaceboAmetaanalysisofthesestudiesKappelleshowedanonsignificantreductioninthepooledrelativeriskofdeathordependencyof(confidenceinterval:–)ThankstotheeffortsofJoseFerroandhiscolleagues,theInternationalStudyonCerebralVeinandDuralSinusThrombosis(ISCVT)wasinitiatedThiscollaborativeinitiativehasnowresultedinseveraljointpapersandhassubstantiallyincreasedourknowledgeHowever,informationobtainedfromtheISCVTisbasedonobservationaldataandinternationalmulticentertrialsarestilltobeawaitedNotonlyaconclusivetrialaboutthetypeanddurationofanticoagulationtherapy,butalsolargetrialsabouttheusefulnessofcorticosteroidsorendovascularthrombolysiswouldaddsubstantiallytoourknowledgeonhowtobesttreatpatientswithCVSTThrombosisofthecerebralveinsmaycausefocaldeficitsduetolocaleffectsofvenousobstruction,butalsomoregeneralizedeffectsasaresultofincreasedcerebrospinalfluidpressurecausedbyblockingofthemajorsinusesInthemajorityofpatients,thesetwoprocessesoccursimultaneouslyThecourseandclinicalfeaturesofCVSTarehighlyvariableItisonlyaftertheintroductionofcomputerizedtomographyand(particularly)magneticresonanceimagingthatverificationofthediagnosisduringlifehasbecomepartofdailyclinicalpracticeandthat,asaresult,theclinicalspectrumofthediseasehasenormouslyincreasedItisnowwellknownthattheclinicalfeaturesofCVSTareextraordinarilyvariableConsequently,thediagnosismaybedifficultTheaveragedelayfromtheonsetofsymptomstothediagnosisisdaysPatientsmaypresenttoanear,noseandthroatsurgeonwithrecurrentearinfectionsandheadache,toapediatricianwithheadacheandvomiting,toanobstetricianbecauseofacomplicatedpregnancyorpuerperium,toanophthalmologistbecauseofblurredvision,toaninternistbecauseofvaguesymptomsinthecontextofasystemicdisease,toaneurologistbecauseofepilepticseizures,ortoaneurosurgeonbecauseofchronicintracranialhypertensionThevarietyofclinicalfeaturesandthelargenumberofspecialistsdealingwiththecareofpatientswithCVSThaveresultedinpapersinpeerreviewedjournalsofmanydifferentdisciplines,makingaclearandconciseoverviewdifficultForthisreason,thecurrentbookeditedbyexpertsinthefieldofstrokefromPerugia,Italy,thatcoversthefullspectrumofCVST,shouldbewelcomedasausefulclinicalguideforallphysicianswhoareinvolvedinthecareofpatientswithCVSTIntroductionReferencesFerroJM,CanhaoP,StamJ,BousserMG,BarinagarrementeriaF:Prognosisofcerebralveinandduralsinusthrombosis:resultsoftheInternationalStudyonCerebralVeinandDuralSinusThrombosis(ISCVT)Stroke:–deBruijnSFTM,StamJ:Randomized,placebocontrolledtrialofanticoagulanttreatmentwithlowmolecularweightheparinforcerebralsinusthrombosisStroke:–StamJ,DeBruijnSFTM,DeVeberG:AnticoagulationforcerebralsinusthrombosisCochraneDatabaseSystRev:CDStamJ:ThrombosisofthecerebralveinsandsinusesNEnglJMed:–ProfLJKappelleUniversityDepartmentofNeurology,UniversityMedicalCenterUtrechtRudolphMagnusInstituteforNeurosciencesNL–CXUtrecht(TheNetherlands)Tel�,Fax�,EMaillkappelleneuroazunlCasoV,AgnelliG,PaciaroniM(eds):HandbookonCerebralVenousThrombosisFrontNeurolNeurosciBasel,Karger,,vol,pp–AnatomyofCerebralVeinsandSinusesTürkerK�l�ça,Ak�nAkak�nbaSectionsofNeurovascularandNeurooncologicalSurgery,bDepartmentofNeurosurgery,MarmaraUniversity,Istanbul,TurkeyAbstractTheveinsofthebrainhavenomusculartissueintheirthinwallsandpossessnovalvesTheyemergefromthebrainandlieinthesubarachnoidspaceTheypiercethearachnoidmaterandthemeningeallayeroftheduraanddrainintothecranialvenoussinusesThecerebralvenoussystemcanbedividedintoasuperficialandadeepsystemThesuperficialsystemcomprisessagittalsinusesandcorticalveins,whichdrainsuperficialsurfacesofbothcerebralhemispheresThedeepsystemconsistsofthelateralsinus,straightsinusandsigmoidsinusalongwithdrainingdeepercorticalveinsBothofthesesystemsmostlydrainintointernaljugularveinsGenerally,venousblooddrainsintothenearestvenoussinusor,inthecaseofblooddrainingfromthedeepeststructures,intodeepveinsThesuperficialcerebralveinsareinterlinkedwithanastomoticveinsofTrolardandLabbéThus,thesuperolateralsurfaceofthehemispheredrainsintothesuperiorsagittalsinuswhiletheposteroinferioraspectdrainsintothetransversesinusTheveinsoftheposteriorfossaarevariableincourse,andangiographicdiagnosisoftheirocclusionisdifficultTheentiredeepvenoussystemisdrainedbyinternalcerebralandbasalveins,whichjointoformthegreatveinofGalenthatdrainsintothestraightsinusThoughvariationinthesuperficialcerebralvenoussystemisarule,anatomicconfigurationofthedeepvenoussystemcanbeusedasanatomiclandmarksSincethrombosisorsurgicalsacrificeofthecerebralveinsmayleadtovenousinfarctionwithseriouscomplications,angiographicandsurgicalanatomyofthevenoussystemshouldbeseriouslyinvestigatedforeachindividualpatientCopyright©SKargerAG,BaselCerebralVenousSystemUnderstandingcerebralvenoussystemisimportanttodescribethepathophysiologyandtreatmentofcerebralvenousthrombosisEspeciallywhensurgeryisplanned,onehastobeabletorecognizethemajorveinsandsinusesandtodescribetheirdirectionofflowAsurgerythatinvolvessacrificingsomeAnatomyofCerebralVeinsandSinusesmajorcorticalveinsorsubduralbridgingveinscarriesariskofvenousinfarction,andveindamagemustthereforebekepttoaminimumduringsurgeryTheveinsofthebrainhavenomusculartissueintheirverythinwallsTheypossessnovalvesandemergefromthebrainandlieinthesubarachnoidspaceTheypiercethearachnoidmaterandthemeningeallayeroftheduraanddrainintothecranialvenoussinusesMostofthecerebralvenousdrainagecollectsultimatelyintothetransverseandsigmoidsinusesoftheskullbaseThecerebralveinsaredividedintothesuperficialanddeepgroupsThesuperficialgroupdrainsthecorticalsurfacesThedeepgroupdrainsthedeepwhiteandgraymatterandcollectsintochannelsthatcoursethroughthewallsoftheventriclesandbasalcisternstodrainintotheinternalcerebral,basal,andgreatveins,Cerebralvenoussystemcanbedescribedinparts:()superficialsupratentorialcorticalveins()duralsinusesandveins()meningealveins()deepveins()posteriorfossaveinsSuperficialSupratentorialCorticalVeinsThesuperficialveinslieonthesurfaceofthecerebralcortexTheydrainmainlyintothebasalveinofRosenthalandareconsideredpartofthedeepdrainagesystemSuperficialveinsdrainmainlyintofourmajorveinsorgroupsofbridgingveins,:()superiorsagittalsinusthatreceivesthesuperiorsagittalgroup()sphenoparietalsinusandcavernoussinusthatreceivethesphenoidalgroup()inferiorsagittalsinusandveinofGalenthatreceivethefalcinegroup,and()tributariesofthesinusesrelatedtotentoriumcerebellithatreceivethetentorialgroupAnatomySuperiorSagittalGroupThisvenoussinusliesinthemedianplane,alongtheattachedborderofthefalxcerebriItincludestheveinsfromthesuperiorpartofthemedialandlateralsurfacesofthefrontal,parietalandoccipitallobes,andfromtheanteriorpartoftheorbitalsurfaceofthefrontallobeSphenoidalGroupTheseveinsdrainintothesphenoparietalorcavernoussinusand,lesscommonly,intothesphenobasalorsphenopetrosalsinusesK�l�çAkak�nFalcineGroupThefalcinegroupisformedbytheveinsthatemptyintotheinferiorsagittalorstraightsinus,eitherdirectlyorthroughtheinternalcerebral,basalandgreatveinsThisgroupisresponsiblefordrainageofthelimbicsystemTheveinsontheparaterminalandparaolfactorygyridrainposteriorlytowardtheanteriorcerebralveinTheanteriorpartsofthecingulatedgyrusandcorpuscallosumaredrainedbytheanteriorpericallosalveinsTheposteriorpartofthecingulategyrusisdrainedbytheposteriorpericallosalveinthemedialpartoftheparahippocampalgyrusanduncusaredrainedbytheuncal,anteriorhippocampal,andmedialtemporalveins,TentorialGroupThetentorialgroupofbridgingveinsdrainsintothetentorialsinuses,orintothetransverseandsuperiorpetrosalsinusesinthetentorialmarginsThisgroupincludesthetemporobasalandoccipitobasalveins,andthedescendingveins,includingtheveinofLabbéTheveinofLabbéusuallyentersthetransversesinusNormalAngiographicAnatomyLateralViewOnlateralangiography,–superiorcorticalveinscanbeidentifiedIntheanteriorfrontalregion,corticalveinsenterthesuprasagittalsinusSuperficialmiddlecerebralveinscanbeidentifiedonlateralprojectionsduringthevenousphaseofcarotidangiographyTheveinofTrolardisalsobestidentifiedonthelateralviewduringthemidtolatevenousphaseofcerebralangiogramsItisalargeanatomiccorticalveinthatcoursesfromthesuperficialmiddlecerebralveintosuperiorsagittalsinusandistheprominentsuperficialveinonthenondominantsideatthelatevenousphase(fig)AnteriorPosteriorViewOnanteriorposterior(AP)projections,theveinofTrolardappearstoparalleltheinnertableoftheskullasitcurvesupwardandcoursesoverthecerebralconvexityTheveinofLabbéisalargecorticalveinthatcoursesfromthesuperficialmiddlecerebralveintothetransversesinusandistheprominentsuperficialveinonthedominantsideAnatomyofCerebralVeinsandSinusesInferiorsagittalsinusSuperiorsagittalsinusVeinofGalenStraightsinusStraightsinusInternalcerebralveinInternalcerebralveinsBasalveinBasalveinLateralsinusLateralsinusabFigaAngiographicvenousphaseofcarotidangiogramandMRvenographybSchematicpresentationofthecerebralvenoussystem:superiorsagittalsinus(),veinofTrolard(),inferiorsagittalsinus(),superficialmiddlecerebralvein(),veinofLabbé(),straightsinus(sinusrectus)(),torculaherophili(),transversesinus()K�l�çAkak�nDuralSinusesandVeinsTheduralsinusesreceivecerebralveinsfromthesuperficialanddeeppartsTheseare:()superiorandinferiorsagittal()straight()transverse()tentorial()cavernous()superiorpetrosalSuperiorandInferiorSagittalSinusesSuperiorsagittalsinussuperiorlyattachedtothefalxcerebriendswithcristagalliInaboutofcases,superiorsagittalsinusendsbybecomingtherighttransversesinusAttheterminationofthesuperiorsagittalsinusisadilatation,knownasconfluenceofthesinusesItisalsoknownastorculaherophiliThesuperiorsagittalsinusalsocommunicateswithveinsinthescalpthroughemissaryveinsthatpassthroughtheparietalforaminaThecorticalveinsmaypassdirectlytothesuperiorsagittalsinus,ortheymayjointhemeningealsinuses,whichemptyintothesuperiorsagittalsinusInferiorsagittalsinusoccupiestheposteriortwothirdsofthefreeinferioredgeofthefalxcerebriItendsbyjoiningthegreatcerebralveintoformstraightsinusThelargesttributariesoftheinferiorsagittalsinusaretheanteriorpericallosalveinsStraightSinusesThisvenoussinusisformedbytheunionoftheinferiorsagittalsinuswiththegreatcerebralveinItisattachedtothetentoriumcerebelliItmaydrainintoeitherthetransversesinusor,mostcommonly,thelefttransversesinusTransverseSinusesThesevenoussinusespasslaterallyfromtheconfluenceofthesinusesintheattachedborderofthetentoriumcerebelliTherighttransversesinus,whichisusuallylarger,receivesthemajorityofthedrainagefromthesuperiorsagittalsinusSowecanguessthattherighttransversesinus,rightsigmoidsinusandrightjugularveincontainbloodfromthesuperficialpartsofthebrain,andthelefttransversesinus,leftsigmoidsinusandleftinternaljugularveincontainbloodmainlyfromthedeeppartsofthebraindrainedbytheinternalcerebral,basalandgreatveinsTentorialSinusesThesesinusesdivideintothemedialandlateralgroupsThemedialgroupdrainsintotransversesinusesandthelateralgroupdrainsintobothstraightandtransversesinusesAnatomyofCerebralVeinsandSinusesCavernousSinusesTheselargesinusesareaboutcmlongandcmwideThey

用户评价(0)

关闭

新课改视野下建构高中语文教学实验成果报告(32KB)

抱歉,积分不足下载失败,请稍后再试!

提示

试读已结束,如需要继续阅读或者下载,敬请购买!

评分:

/38

VIP

在线
客服

免费
邮箱

爱问共享资料服务号

扫描关注领取更多福利