Presto Peyton, D'Souza Preston, Kopacz Avery, Hanson Keith A, Nagy Laszlo
Department of Pediatrics, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, United States.
Department of Pediatrics, University Medical Center Health System, Lubbock, Texas, United States.
J Neurosci Rural Pract. 2020 Jul;11(3):430-435. doi: 10.1055/s-0040-1712717. Epub 2020 Jun 1.
Febrile seizures have been shown to occur in 2 to 5% of children between the ages of 6 months and 5 years, making them the most common seizures of childhood. Multiple risk factors for febrile seizures have been identified; however, no investigation has been conducted to explore foramen size and associated venous drainage as a potential risk factor for experiencing febrile seizures. Of particular interest are the parietal foramen and the condylar canal, which conduct the parietal emissary vein and the occipital emissary vein, respectively. Emissary veins lack valves, allowing them to play a crucial role in selective brain cooling via a bidirectional flow of blood from the head's evaporating surface. Narrowed cranial apertures conducting these veins may lead to reduced cerebral venous outflow and delayed brain cooling, creating favorable conditions for a febrile event. This study seeks to explore the association between cranial aperture area and febrile seizure status. A retrospective cross-sectional medical record review study from January 2011 to December 2017 was conducted at a 500-bed academic hospital and a 977-bed private hospital in Lubbock, Texas, United States. A total of 101 complex febrile seizure patients were compared with a similarly aged group of 75 trauma patients representing the normal population. Parietal foramen area and condylar canal area were electronically measured and defined as having "normal" or "below normal" area. Independent -tests were used to compare foramen and canal areas by febrile seizure status. Logistic regression analyses were conducted to determine the association of small cranial aperture area with febrile seizure status. Below normal parietal foramen area had a strong association with febrile seizures in our patient population. Male sex, white race, and complete vaccination status were also found to have significant associations with febrile seizure status. Our findings indicated that narrowed parietal foramen may be considered as a risk factor for febrile seizure development.
发热性惊厥在6个月至5岁的儿童中发生率为2%至5%，是儿童期最常见的惊厥类型。已确定了多个发热性惊厥的风险因素；然而，尚未开展研究探讨孔大小及相关静脉引流作为发热性惊厥潜在风险因素的情况。特别值得关注的是顶骨孔和髁管，它们分别传导顶骨导静脉和枕骨导静脉。导静脉没有瓣膜，这使其在通过头部蒸发表面的双向血流进行选择性脑冷却过程中发挥关键作用。传导这些静脉的颅骨孔变窄可能导致脑静脉流出减少和脑冷却延迟，从而为发热事件创造有利条件。本研究旨在探讨颅骨孔面积与发热性惊厥状态之间的关联。
2011年1月至2017年12月，在美国得克萨斯州拉伯克市一家拥有500张床位的学术医院和一家拥有977张床位的私立医院开展了一项回顾性横断面病历审查研究。将101例复杂性发热性惊厥患者与75例年龄相仿的创伤患者组成的代表正常人群的对照组进行比较。通过电子测量顶骨孔面积和髁管面积，并将其定义为“正常”或“低于正常”面积。
采用独立t检验按发热性惊厥状态比较孔和管的面积。进行逻辑回归分析以确定小颅骨孔面积与发热性惊厥状态之间的关联。
在我们的患者群体中，低于正常的顶骨孔面积与发热性惊厥密切相关。还发现男性、白种人和完全接种疫苗状态与发热性惊厥状态也有显著关联。
我们的研究结果表明，顶骨孔变窄可能被视为发热性惊厥发生的一个风险因素。
