뇌경막 정맥동 혈전증 - 증례보고 -

Cerebral Dural Sinus Thrombosis - Case Report -

  • 한영민 (한림대학교 의과대학 성심병원 신경외과학교실) ;
  • 이종필 (한림대학교 의과대학 성심병원 신경외과학교실) ;
  • 황형식 (한림대학교 의과대학 성심병원 신경외과학교실) ;
  • 임대철 (한림대학교 의과대학 성심병원 신경외과학교실) ;
  • 송준호 (한림대학교 의과대학 성심병원 신경외과학교실) ;
  • 안명수 (한림대학교 의과대학 성심병원 신경외과학교실)
  • Han, Young-Min (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Lee, Jong-Phil (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Hwang, Hyung-Sik (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Lim, Dae-Chul (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Song, Joon-Ho (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Ahn, Myung-Su (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
  • 투고 : 2000.08.18
  • 심사 : 2001.03.22
  • 발행 : 2001.03.28

초록

경막정맥동 혈전증은 다양한 원인을 가진 비교적 드문 질환으로 알려져왔으며 임상양상 및 발현형태가 매우 다양하여 임상적 진단이 쉽지 않았다. 그러나 최근에는 여러 영상진단 방법, 특히 자기공명영상 혈관 촬영등을 통해 조기 진단이 가능하게되었다. 치료 방법을 결정할 때, 환자의 임상증상과 정맥순환계의 개인간 차이가 매우 중요한 인자중 하나이다. 저자들은 보존적 치료로 좋은 결과를 얻은 2례의 경막정맥동 환자의 특성을 문헌고찰과 함께 보고하는 바이다.

Cerebral dural sinus thrombosis(CDST) has been described as a rare disease with a variety of patho-etiological factors. The diagnosis of CDST is difficult due to various symptoms and signs, none of which is specific to CDST. But timely diagosis is critical for effective management. The introduction and widespread use of computed tomography(CT), magnetic resonance imaging(MRI) and cerebral angiography made early diagnosis of CDST possible. In particular, MR venography is the most useful tool for establishing a correct diagnosis quickly. In early literature, mortality ranked between 30% and 50% but in more recent series it is between 5.5% and 30%. With the advent of diagnostic and therapeutic tools, early diagnosis and proper management has made the prognosis better. The appropriate therapy for CDST, however, has been the subject of much cortroversy. Individual variations of the venous system and collateral vessels are key factors to decide the proper treatment. In this report, we present two cases with symptomatic CDST treated without open surgical or direct endovascular interventions with good outcome.

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