Soman Teesta B, Moharir Mahendranath, DeVeber Gabrielle, Weiss Shelly
Division of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
J Child Neurol. 2006 Feb;21(2):126-31. doi: 10.1177/08830738060210021001.
Cerebral sinovenous thrombosis is a rare but potentially serious condition often occurring in children with nonspecific presenting features. Much remains to be learned about the long-term outcome of infants with cerebral sinovenous thrombosis. We report a series of four patients taken from a prospective database of neonates with sinovenous thrombosis who subsequently developed infantile spasms, three with hypsarrythmia on electroencephalography and one with multiple independent spike foci. The first patient presented at 2 weeks of age with hypernatremia, dehydration, and seizures. He was found to have extensive thrombosis and hemorrhagic infarction of the right basal ganglia. The second patient presented at 5 weeks of life and was found to have sagittal sinus thrombosis with bilateral intracranial hemorrhage. The third patient presented with seizures on day 1 of life and was found to have venous thrombosis involving the torcular, extending into the sagittal sinus. The fourth patient presented at 3 weeks with lethargy and seizures. He was diagnosed with bacterial meningitis and also had extensive sinus thrombosis. All patients developed infantile spasms at ages 9, 7, 11, and 10 months, respectively. This is the first report in the English literature describing infantile spasms as a possible outcome of sinovenous thrombosis in early infancy.
脑静脉窦血栓形成是一种罕见但可能严重的疾病，常发生于具有非特异性表现的儿童。关于脑静脉窦血栓形成的婴儿的长期预后，仍有许多有待了解的地方。我们报告了一系列4例患者，这些患者来自一个患有静脉窦血栓形成的新生儿前瞻性数据库，随后均出现了婴儿痉挛症，其中3例脑电图检查显示有高度节律失调，1例有多个独立的棘波灶。首例患者在2周龄时出现高钠血症、脱水和癫痫发作。发现其右侧基底节有广泛血栓形成和出血性梗死。第二例患者在5周龄时就诊，发现有矢状窦血栓形成伴双侧颅内出血。第三例患者在出生第1天出现癫痫发作，发现静脉血栓形成累及窦汇，并延伸至矢状窦。第四例患者在3周龄时出现嗜睡和癫痫发作。他被诊断为细菌性脑膜炎，同时也有广泛的静脉窦血栓形成。所有患者分别在9、7、11和10个月龄时出现婴儿痉挛症。这是英文文献中首次报道婴儿痉挛症可能是婴儿早期静脉窦血栓形成的一种结局。
