de Haan T R, Padberg R D, Hagebeuk E E O, Aronica E, van Rijn R R, Majoie C B L M, Kok J H
Department of Paediatrics, Division of Neonatology, Academic Medical Centre, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands.
Eur J Paediatr Neurol. 2008 Jan;12(1):41-5. doi: 10.1016/j.ejpn.2007.04.003. Epub 2007 May 29.
We report a case of neonatal dural sinus malformation already visible on antenatal ultrasound. This is a rare disease entity in infants and children. Clinical diagnosis was made by demonstrating a cranial murmur on auscultation; macrocrania and signs of progressive cardiac failure. Imaging studies as cerebral ultrasound, postnatal MRI scan and MR angiography demonstrated a large dural sinus malformation originating from the sagittal sinus with extensive arteriovenous fistulae. Due to the extent of the lesion, the existing ischemic brain damage and involvement of the torcular, no therapeutic options were available and the child died of irreversible cardiac failure. The diagnosis was confirmed with autopsy. We discuss the clinical presentation, imaging and neuropathological results and relate our findings to embryological data and the existing literature.
我们报告一例产前超声即可发现的新生儿硬脑膜窦畸形。这在婴幼儿中是一种罕见的疾病实体。临床诊断依据听诊时发现颅骨杂音、巨头症及进行性心力衰竭体征。脑部超声、产后磁共振成像扫描及磁共振血管造影等影像学检查显示,一个源于矢状窦的大型硬脑膜窦畸形,伴有广泛动静脉瘘。由于病变范围、已存在的缺血性脑损伤以及窦汇受累,没有可用的治疗方案,患儿死于不可逆的心力衰竭。尸检确诊了诊断。我们讨论了临床表现、影像学及神经病理学结果,并将我们的发现与胚胎学数据及现有文献相关联。