Department of Pediatrics, Room 3A, McMaster University, 1200 Main St W, Hamilton, Ontario, Canada L8S 4J9.
Pediatrics. 2010 Sep;126(3):e693-700. doi: 10.1542/peds.2010-1035. Epub 2010 Aug 9.
Although cerebral sinovenous thrombosis (CSVT) is an uncommon disorder in neonates, the incumbent morbidity, mortality, and adverse neurodevelopmental sequelae highlight the importance of establishing an early diagnosis with an appropriate therapeutic plan. The clinical signs and symptoms of the condition are subtle and invariably masquerade under the umbrella of a broad spectrum of neonatal illnesses. A high index of diagnostic suspicion is essential for investigating and initiating treatment in a timely fashion before major complications ensue. Recent advances in accessible radiographic techniques with reduced radiation exposure have facilitated rapid diagnosis of thrombosis in both the superficial and deep plexuses of the cerebral venous systems. The absence of large-scale randomized trials and solid prospective smaller-sample-sized studies of neonates with CSVT has compromised our ability to develop efficacious treatment decisions. In this review of the scientific literature we offer understanding of the complex etiology of CSVT and inherent problems involved in the diagnosis and treatment of the disorder and focus on the limitations in current follow-up. An approach to neonatal CSVT is proposed on the basis of the available evidence from guidelines, registries, prospective and retrospective infant studies, and case series.
尽管脑静脉窦血栓形成（CSVT）在新生儿中较为少见，但该病的发病率、死亡率和不良神经发育后遗症很高，这突出了早期诊断和制定适当治疗方案的重要性。该病的临床体征和症状较为微妙，通常会被掩盖在新生儿各种疾病的表象之下。因此，需要高度怀疑诊断，并在出现严重并发症之前及时进行调查和治疗。最近，由于可获得的放射技术进步，辐射暴露减少，这有助于快速诊断脑静脉系统浅丛和深丛的血栓形成。由于缺乏大规模的随机试验和针对 CSVT 新生儿的大型前瞻性小样本研究，限制了我们制定有效治疗决策的能力。在对科学文献的回顾中，我们深入了解 CSVT 的复杂病因，以及在诊断和治疗该病时所涉及的固有问题，并重点关注当前随访中的局限性。根据指南、登记处、前瞻性和回顾性婴儿研究以及病例系列中提供的现有证据，我们提出了一种针对新生儿 CSVT 的治疗方法。
