摘要：

目的: 报道1例贫血致复发性脑静脉血栓形成患者的临床及典型影像学特征，并复习相关文献，旨在提高对复发性脑静脉血栓形成的认识。方法与结果: 女性患者，38岁，首发症状为视物变形、阅读障碍，血红蛋白显著降低、血小板计数增加，MRI + MRV提示左侧横窦及乙状窦血栓形成，诊断为脑静脉血栓形成继发静脉性脑梗死伴重度贫血，予抗凝治疗及纠正贫血治疗后好转，3个月后自行停用抗凝药物；1年后脑静脉血栓形成复发，MRI + MRV提示皮质静脉血栓形成，再次行抗凝治疗，症状改善。结论: 存在贫血等高凝诱发因素的患者出现神经功能缺损、癫痫发作时，应高度怀疑脑静脉血栓形成，结合影像学检查可明确诊断。脑静脉血栓形成应在积极病因治疗的同时，予以足疗程抗凝治疗，避免复发。

关键词: 静脉血栓形成, 脑静脉, 复发, 贫血, 磁共振成像

Abstract:

Objective: To report the clinical and typical imaging features of a patient with recurrent cerebral venous thrombosis (CVT) secondary to anemia, and to review the relevant literatures in order to enhance the understanding of recurrent CVT. Methods and Results: A 38 - year - old female patient initially presented with metamorphopsia and reading difficulties. Laboratory tests revealed significant decrease in hemoglobin and increase in platelet count. MRI and MRV showed thrombosis of the left transverse and sigmoid sinuses. She was diagnosed with CVT with secondary venous infarction and severe anemia. After anticoagulation therapy and treatment to correct the anemia, the condition improved. However, she stopped anticoagulation therapy on her own after 3 months. One year later, she experienced a recurrence of CVT. MRI and MRV showed cortical venous thrombosis. Anticoagulation therapy was restarted, and the symptoms improved. Conclusions: In patients with anemia and other hypercoagulable risk factors, CVT should be highly suspected when neurological deficits or epileptic seizures occur. A definitive diagnosis can be made with imaging findings. CVT requires both active etiological treatment and adequate anticoagulation therapy to prevent recurrence.

Key words: Venous thrombosis, Cerebral veins, Recurrence, Anemia, Magnetic resonance imaging