Brucknerova Ingrid, Kaldararova Monika, Gajdos Marek, Mach Mojmir, Dubovicky Michal, Ujhazy Eduard
1st Department of Paediatrics, Medical School, Comenius University, Bratislava, Slovakia.
Neuro Endocrinol Lett. 2011;32 Suppl 1:5-7.
Asphyxia of the newborn has a varied etiology. Clinical consequences have a broad spectrum of presentations. Arteriovenous malformation associated with an aneurysm of the Galen vein can be the cause of focal ischemic changes in the nervous parenchyma.
The authors report a case of a term newborn (birth weight 4, 000 grams, Apgar score 7/9). Physical investigation confirmed the presence of a continuous murmur in the area of the anterior fontanelle. Ultrasonic investigation of the brain detected a huge arteriovenous malformation of the Galen vein. Ultrasonic investigation of the heart excluded structural anomaly, but confirmed a huge retrograde flow in the aorta descendens, opened ductus arterious with suspected formation of coarctation of the aorta and dilatation of the vena cava superior.
Congenital anomaly of the Galen vein has a negative influence on prenatal and postnatal development of the brain of a newborn. In the case of our patient, it led to rapid severe asphyxiated changes of the brain parenchyma. Diagnosis and management were established, yet endovascular therapy was not indicated in the early neonatal period.
新生儿窒息病因多样。临床后果表现广泛。与大脑大静脉动脉瘤相关的动静脉畸形可能是神经实质局灶性缺血改变的原因。
作者报告一例足月儿（出生体重4000克，阿氏评分7/9）。体格检查证实前囟区域存在连续性杂音。脑部超声检查发现大脑大静脉巨大动静脉畸形。心脏超声检查排除结构异常，但证实降主动脉存在巨大逆流、动脉导管未闭，怀疑有主动脉缩窄形成及上腔静脉扩张。
大脑大静脉先天性异常对新生儿大脑的产前和产后发育有负面影响。就我们的患者而言，它导致脑实质迅速出现严重窒息性改变。已确立诊断和治疗方案，但在新生儿早期未行血管内治疗。
