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新生儿脑静脉窦血栓形成

Neonatal cerebral sinovenous thrombosis.

作者信息

Ramenghi Luca A, Govaert Paul, Fumagalli Monica, Bassi Laura, Mosca Fabio

机构信息

Neonatal Intensive Care Unit-Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, University of Milan, Via Commenda 12, 20122 Milan, Italy.

出版信息

Semin Fetal Neonatal Med. 2009 Oct;14(5):278-83. doi: 10.1016/j.siny.2009.07.010. Epub 2009 Aug 20.

Abstract

Cerebral sinovenous thrombosis (CSVT) is an uncommon condition among paediatric patients involving major sinuses, with a preponderant occurrence in neonates. The clinical presentation is unspecific, either early, within 48h from birth, or later. An early presentation may be accompanied by several comorbidities (respiratory distress, poor tone, fetal distress, asphyxia), whereas a later presentation is more often associated with conventional neurological signs such as seizures, lethargy, apnoea and poor feeding. These differences in clinical presentation render the neuroradiological diagnosis difficult, in particular before the introduction of magnetic resonance imaging. The interest in CSVT is based on the complex pathogenesis, often resulting from a combination of inherited and acquired thrombophilic patterns. In addition, the course of CSVT can be influenced by medical treatment, currently based on the consensus of experts more than on randomised trials.

摘要

脑静脉窦血栓形成(CSVT)在涉及主要静脉窦的儿科患者中是一种罕见疾病,在新生儿中更为常见。临床表现不具有特异性,可在出生后48小时内早期出现,也可在较晚时候出现。早期表现可能伴有多种合并症(呼吸窘迫、肌张力低下、胎儿窘迫、窒息),而较晚出现的表现则更常与传统的神经系统体征相关,如癫痫发作、嗜睡、呼吸暂停和喂养困难。这些临床表现的差异使得神经放射学诊断变得困难,尤其是在磁共振成像出现之前。对CSVT的关注基于其复杂的发病机制,这通常是由遗传性和获得性血栓形成倾向模式共同导致的。此外,CSVT的病程可能会受到医学治疗的影响,目前这种治疗更多是基于专家共识而非随机试验。

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