文档介绍：●横窦和乙状窦统称为侧窦。●病因以耳或乳突的急慢性感染最为常见。其感染途径为: 直接途径直接途径: : 如中耳炎或乳突炎化脓破坏薄的骨质, 而后脓肿压迫横窦,使窦内血流淤滞并伴有炎性改变。间接途径间接途径: : 乳突炎或中耳炎使通向乙状窦的小静脉发生血栓,而后血栓扩展到乙状窦,开始为附壁血栓, 后渐扩大为静脉窦血栓。横窦和乙状窦血栓横窦和乙状窦血栓(transverse and sigmoid sinus thrombosis) (transverse and sigmoid sinus thrombosis) 脑静脉脑静脉窦血栓窦血栓 1 ●临床表现◆一侧橫窦闭塞时可无症状。◆当对侧橫窦或窦汇先天异常,颅内静脉仅依赖一侧橫窦回流易导致颅内压增高。◆不同的症状取决于血栓的大小和累及的结构■横窦血栓向下扩展至岩下窦向下扩展至岩下窦时,造成外展神经麻痹。■扩展至颈静脉扩展至颈静脉时,可影响到 IX 、X、 XI 颅神经。■血栓向前扩展至岩上窦向前扩展至岩上窦时,压迫三叉神经节或三叉神经第一支。■血栓经窦汇或下吻合静脉扩展到上矢状窦经窦汇或下吻合静脉扩展到上矢状窦时,会产生严重的颅内压增高、昏迷、癫痫、偏瘫或截瘫。■左侧横窦血栓累及到皮层左侧横窦血栓累及到皮层时,可出现失语。横窦和乙状窦血栓横窦和乙状窦血栓(transverse and sigmoid sinus thrombosis) (transverse and sigmoid sinus thrombosis) 脑静脉脑静脉窦血栓窦血栓 2横窦和乙状窦血栓横窦和乙状窦血栓(transverse and sigmoid sinus thrombosis) (transverse and sigmoid sinus thrombosis) 脑静脉脑静脉窦血栓窦血栓 Caption: A 23-year-old female with headache. CT scan demonstrates a subtle right transverse sinus thrombosis with high attenuation (arrows). MR venography demonstrates absent flow in the right transverse sinus, sigmoid sinus, and internal jugular vein. 3横窦和乙状窦血栓横窦和乙状窦血栓(transverse and sigmoid sinus thrombosis) (transverse and sigmoid sinus thrombosis) 脑静脉脑静脉窦血栓窦血栓 A 32-year-old postpartum patient with headaches. Axial CT image shows a hypodense left temporal lobe venous infarct. A triangular high-attenuation focus (arrows) posterolateral to the area of infarction represents thrombus within the left transverse sinus . Axial MR venogram demonstrates occlusion of the left transverse sinus, sigmoid sinus, and internal jugular vein. 4横窦和乙状窦血栓横窦和乙状窦血栓(transverse and sigmoid sinus thrombosis) (transverse and sigmoid sinus thrombosis) 脑静脉脑静脉窦血栓窦血栓 CT scan demonstrates : a lef t p osterior temporal hematoma in a 38-year-old woman on oral contraceptives . Contrast-enhanced MRI showing lack of filling of left transverse sinus. Axial view of MR venogram de