ИСТИНА

Neuro-ophthalmological symptoms were evaluated in 65 patients with cerebral venous sinus thrombosis (CVST). The superior sagittal sinus and lateral sinuses were identified as the most commonly affected sinuses. Risk factors for CVST included congenial coagulopathies, pregnancy and oral contraceptives. Acute and subacute CVST (36 patients) characterized by focal neurological deficits/seizures in 10 patients (27%), papilledema in 31 NEURO-OPHTHALMOLOGY S39 Downloaded by [46.39.47.10] at 10:56 02 November 2017 patients (86%). Visual disturbances due to papilledema, macular edema and hemorrhages were revealed in 7 patients (19.4%). Anticoagulant therapy was used in all patients. It was successful in 19 patients. Fourteen patients were successfully treated with local endovascular thrombolysis with Actilyse (rtPA), Prourokinase, Urokinase, in one case with mechanical thrombus extraction. Three patients required lumboperitoneal shunting for intracranial hypertension. Chronic CVST (29 patients) presented with focal neurological deficits in 2 patients (6.9%). All 29 patients had papilledema. Visual impairment due to marked papilledema or post papilledema secondary optic atrophy were revealed in 17 of 29 patients (58.6%). Fifteen patients required lumboperitoneal shunting for worsening vision. Patients with CVST requires collaboration between neurologists, hematologists, neurosurgeons, radiologists and ophthalmologists. Papilloedema is the most frequent neuroophthalmological symptom in patients with CSVT. Focal neurological deficits are more common in patients with acute and subacute CVST. The role of endovascular thrombolysis in treatment CVST should be discussed. Chronic CVST accompanied by papilledema and vision impairment requires lumbar-peritoneal shunting.