Ramenghi Luca A, Cardiello Valentina, Rossi Andrea
Neonatal Intensive Care Unit, Giannina Gaslini Children's Hospital, Genova, Italy.
Neonatal Intensive Care Unit, Giannina Gaslini Children's Hospital, Genova, Italy.
Handb Clin Neurol. 2019;162:267-280. doi: 10.1016/B978-0-444-64029-1.00012-6.
Cerebral sinovenous thrombosis (CSVT) is a focal or diffuse disruption of cerebral blood flow secondary to occlusion of cerebral veins and/or sinuses. The challenge of CSVT during the neonatal age has led to a great interest in this condition among neonatologists, child neurologists, and pediatric neuroradiologists. The highly variable clinical spectra, etiologies, and prognosis require fine medical skills and a high level of suspicion. Nevertheless, the diagnosis is often delayed or missed altogether. Differences in brain vulnerability at different stages of maturation may explain the spectrum of associated brain lesions, which varies with gestational age. Treatment is controversial and reported clinical outcomes vary widely. The controversial treatment of CSVT with anticoagulant therapy is based only on case series and expert consensus, there is lack of safety data.
脑静脉窦血栓形成(CSVT)是继发于脑静脉和/或静脉窦闭塞的局灶性或弥漫性脑血流中断。新生儿期CSVT的挑战引起了新生儿科医生、儿童神经科医生和儿科神经放射科医生对这种疾病的极大关注。其临床表现、病因和预后差异很大,需要精湛的医疗技术和高度的怀疑意识。然而,诊断往往会延迟或完全漏诊。不同成熟阶段脑易损性的差异可能解释了相关脑损伤的范围,其随胎龄而变化。治疗存在争议,报告的临床结果差异很大。CSVT抗凝治疗存在争议,其仅基于病例系列和专家共识,缺乏安全性数据。